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Table 3 Summary of the clinical effectiveness papers by endpoint type

From: How is overall survival assessed in randomised clinical trials in cancer and are subsequent treatment lines considered? A systematic review

 

Primary or co-primary (n=45)

Secondary (n=48)

Exploratory (n=5)

Total (n=98)

Was a Kaplan-Meier curve for OS presented in the main text?

 Yes

40 (88.9%)

41 (85.4%)

5 (100.0%)

86 (87.8%)

 No

2 (4.4%)

6 (12.5%)

0 (0.0%)

8 (8.2%)

 N/Aa

3 (6.7%)

1 (2.1%)

0 (0.0%)

4 (4.1%)

Were the numbers at risk included in the Kaplan-Meier curve?

 Yes

36 (80.0%)

38 (79.2%)

5 (100.0%)

79 (80.6%)

 No

4 (8.9%)

3 (6.3%)

0 (0.0%)

7 (7.1%)

 N/A

5 (11.1%)

7 (14.6%)

0 (0.0%)

12 (12.2%)

Were the number of patients censored or number of events included in the at risk table

 Yes

9 (20.0%)

3 (6.3%)

1 (20.0%)

13 (13.3%)

 No

27 (60.0%)

35 (72.9%)

4 (80.0%)

66 (67.3%)

 N/A

9 (20.0%)

10 (20.8%)

0 (0.0%)

19 (19.4%)

Were confidence intervals included in the Kaplan-Meier curve?

 No

40 (88.9%)

41 (85.4%)

5 (100.0%)

86 (87.8%)

 N/A

5 (11.1%)

7 (14.6%)

0 (0.0%)

12 (12.2%)

Primary analysis

 Hazard ratio and 95% CI from an unadjusted Cox model

1 (2.2%)

0 (0.0%)

0 (0.0%)

1 (1.0%)

 Hazard ratio and 95% CI from an adjusted Cox model

1 (2.2%)

1 (2.1%)

0 (0.0%)

2 (2.0%)

 Hazard ratio and P-value from a logrank test

8 (17.8%)

11 (22.9%)

0 (0.0%)

19 (19.4%)

 Hazard ratio and P-value from a stratified logrank test.

3 (6.7%)

3 (6.3%)

0 (0.0%)

6 (6.1%)

 Hazard ratio and p-value from an adjusted Cox model

12 (26.7%)

2 (4.2%)

1 (20.0%)

15 (15.3%)

 Hazard ratio and p-value from an unadjusted Cox model

2 (4.4%)

3 (6.3%)

0 (0.0%)

5 (5.1%)

 Hazard ratio from a Cox model and p-value from a logrank test

3 (6.7%)

7 (14.6%)

0 (0.0%)

10 (10.2%)

 Hazard ratio from an adjusted Cox model and p-value from a logrank test.

2 (4.4%)

4 (8.3%)

0 (0.0%)

6 (6.1%)

 Hazard ratio from an adjusted Cox model and p-value from a stratified logrank test.

5 (11.1%)

5 (10.4%)

3 (60.0%)

13 (13.3%)

 Hazard ratio from an unadjusted Cox model and p-value from a logrank test.

1 (2.2%)

4 (8.3%)

0 (0.0%)

5 (5.1%)

 Hazard ratio from an unadjusted Cox model and p-value from a stratified logrank test.

0 (0.0%)

2 (4.2%)

0 (0.0%)

2 (2.0%)

 N/Aa

3 (6.7%)

1 (2.1%)

0 (0.0%)

4 (4.1%)

 Other

4 (8.9%)

5 (10.4%)

1 (20.0%)

10 (10.2%)

Were subsequent treatments mentioned in the paper?

 Yes

33 (73.3%)

23 (47.9%)

3 (60.0%)

59 (60.2%)

 No

12 (26.7%)

25 (52.1%)

2 (40.0%)

39 (39.8%)

Was the percentage or number of participants who received later lines included in the main text or appendix?

 Yes

31 (68.9%)

18 (37.5%)

1 (20.0%)

50 (51.0%)

 No

1 (2.2%)

5 (10.4%)

2 (40.0%)

8 (8.2%)

 N/A

13 (28.9%)

25 (52.1%)

2 (40.0%)

40 (40.8%)

Was a breakdown or summary of the number of subsequent treatments (two, three, four) included in the main text or appendix?

 Yes

3 (6.7%)

1 (2.1%)

0 (0.0%)

4 (4.1%)

 No

28 (62.2%)

22 (45.8%)

3 (60.0%)

53 (54.1%)

 N/Ab

14 (31.1%)

25 (52.1%)

2 (40.0%)

41 (41.8%)

Was a breakdown or summary of the type of subsequent treatments (treatment 1, treatment 2, treatment 3) included in the main text or appendix?

 Yes

26 (57.8%)

18 (37.5%)

1 (20.0%)

45 (45.9%)

 No

5 (11.1%)

5 (10.4%)

2 (40.0%)

12 (12.2%)

 N/Ab

14 (31.1%)

25 (52.1%)

2 (40.0%)

41 (41.8%)

Was additional analysis conducted to account for subsequent treatment lines?

 Yes

2 (4.4%)

3 (6.3%)

2 (40.0%)

7 (7.1%)

 No

30 (66.7%)

20 (41.7%)

1 (20.0%)

51 (52.0%)

 N/Ab

14 (31.1%)

25 (52.1%)

2 (40.0%)

41 (41.8%)

Were subsequent treatment lines mentioned in the discussion?

 Yes

22 (48.9%)

15 (31.3%)

2 (40.0%)

39 (39.8%)

 No

11 (24.4%)

8 (16.7%)

1 (20.0%)

20 (20.4%)

 N/A

12 (26.7%)

25 (52.1%)

2 (40.0%)

39 (39.8%)

How were subsequent treatments mentioned in the discussion?

 The uptake of subsequent treatments is given as a reason for the discrepancy between OS and surrogate endpoints.

0 (0.0%)

2 (4.2%)

0 (0.0%)

2 (2.0%)

 The uptake of subsequent treatments is given as a reason for better OS results or a reduced event rate than expected.

4 (8.9%)

1 (2.1%)

1 (20.0%)

6 (6.1%)

 The uptake of subsequent treatments is given as a reason for reduced OS effect/stated as may have affected the results/used to caveat the results.

6 (13.3%)

7 (14.6%)

1 (20.0%)

14 (14.3%)

 The lack of uptake of subsequent treatments is given as a reason for no OS effect/may have negatively affected OS.

4 (8.9%)

0 (0.0%)

0 (0.0%)

4 (4.1%)

 Subsequent treatments are stated to not have affected the OS results as an OS benefit was observed or OS was similar between those who did and did not receive a subsequent treatment.

2 (4.4%)

1 (2.1%)

0 (0.0%)

3 (3.1%)

 Randomisation/balance of subsequent treatment lines is given as a reason as to why subsequent treatment lines will not have affected the OS results.

2 (4.4%)

2 (4.2%)

0 (0.0%)

4 (4.1%)

 None or limited options of subsequent treatment lines for patients are given as a reason as to why subsequent treatment lines will not have affected the OS results.

0 (0.0%)

2 (4.2%)

0 (0.0%)

2 (2.0%)

 Other

4 (8.9%)

0 (0.0%)

0 (0.0%)

4 (4.1%)

 N/A

23 (51.1%)

33 (68.8%)

3 (60.0%)

59 (60.2%)

  1. N/A Not applicable, OS Overall survival
  2. aNot applicable here refers to papers where OS is a pre-specified endpoint, but the data is not mature at the time of the publication [15,16,17,18]
  3. bNote one paper stated no patients received subsequent treatments so is classed as N/A for these summaries