ADAPT‐TN.
Study characteristics | ||
Methods | Accrual: May 2013 to January 2015 Multicentre, 48 sites Phase of trial: 2 Study design: RCT Country or countries where the trial was conducted: Germany Median follow‐up: not reported |
|
Participants | Age: median 50, range 26–75 years Nodal status of breast cancer: node positive 26%, node negative 74% Adjuvant or neoadjuvant: neoadjuvant Notable exclusion criteria: none |
|
Interventions | Arm 1: Nab‐paclitaxel 125 mg/m2 + carboplatin AUC2 days 1 and 8, every 3 weeks for 4 cycles Arm 2: Nab‐paclitaxel 125 mg/m2 + gemcitabine 1000 mg/m2 days 1 and 8, every 3 weeks for 4 cycles |
|
Outcomes | Primary
Secondary
|
|
Notes | Trial registration record: NCT01815242 Not all randomised participants were included in the analysis; 5 excluded prior to receiving treatment (3 in intervention arm, 2 in comparator arm). Safety analysis involved people receiving ≥ 1 dose of trial medication. For DFS and OS, we estimated the hazard ratio using Tierney's method. Study did not report assessing the proportional hazards assumption. Funding considerations: funded by Celgene and Teva. |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Randomisation in a 1:1 ratio, method to generate random sequence was not described. |
Allocation concealment (selection bias) | Low risk | Quote: "Randomisation was performed centrally at West German Study group." |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Participants and personnel were aware of treatment allocation. This may have been associated with some performance bias but it was not judged to be of serious concern given types of outcomes collected. |
Blinding of outcome assessment (detection bias): toxicity | Low risk | Toxicity outcomes graded using the CTCAE. Although the study was open‐label, grading symptoms using the CTCAE is standardised and, therefore, knowing treatment allocation may have had minimal effect on the grading of outcomes. |
Blinding of outcome assessment (detection bias): neoadjuvant studies only: pCR | Low risk | pCR was assessed by a local pathologist only. It is not reported whether this pathologist was blinded to the treatment allocation; however, pCR is viewed to be an objective outcome and unlikely to be influenced by knowledge of treatment allocation. |
Selective reporting (reporting bias) | Low risk | All prespecified primary and secondary endpoints from the trial record were reported in the manuscript and subsequent abstract publications. |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | CONSORT diagram showed that 5/336 randomised participants did not receive treatment and were excluded from analysis. Reasons for exclusions were detailed, including consent withdrawn, and violation of inclusion criteria. Additionally, pCR results for 12 participants were not reported. |
Other bias | Low risk | None identified. |