Zheng 2022.

Study characteristics
Methods	Accrual: June 2009 and October 2015 Multicentre, 3 centres Phase of trial: 2 State study design: open‐label RCT Country or countries where the trial was conducted: China Median follow‐up: 97.6 months
Participants	Age: median 48.4, range 42–56 years Nodal status of breast cancer: 34% node positive, 66% node negative Adjuvant or neoadjuvant: adjuvant Notable exclusion criteria: none
Interventions	Arm 1: docetaxel 75 mg/m2 or paclitaxel 175 mg/m2 + carboplatin AUC5, every 3 weeks for 6 cycles Arm 2: epirubicin 90 mg/m2 + cyclophosphamide 600 mg/m2, every 3 weeks for 4 cycles, followed by docetaxel 75 mg/m2 or paclitaxel 175 mg/m2 every 3 weeks for 4 cycles
Outcomes	Primary DFS, defined as period from the date of pathological diagnosis to the date of first relapse (included local, regional or metastatic) or death from any cause Secondary OS, defined as period from date of pathological diagnosis to the date of death from any cause Toxicity Quality of life (listed in abstract in Journal of Clinical Oncology supplement) Exploratory analyses of germline BRCA status and PD‐L1 expression
Notes	Trial registration record: NCT01150513 All randomised participants were included in intention‐to‐treat analysis. The proportional hazards assumption was assessed and not met. For DFS and OS, we estimated the hazard ratio using Tierney's method. Funding considerations: this work was supported by Special Fund for breast health, Cancer Foundation of China, Capitals Funds for Health Improvement and Research (2018‐2‐4023) and National Natural Science Foundation of China (81672634). The authors stated that the funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomisation in a 1:1 ratio, method not described.
Allocation concealment (selection bias)	Low risk	Randomisation was performed 'centrally' and enroled participants at 3 institutions. It is likely that central allocation was done.
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): DFS	Low risk	Lack of blinding unlikely to influence this outcome.
Blinding of outcome assessment (detection bias): OS	Low risk	Lack of blinding unlikely to influence this outcome.
Blinding of outcome assessment (detection bias): toxicity	Low risk	Toxicity outcomes were graded as per 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.
Selective reporting (reporting bias)	Low risk	All prespecified primary and secondary outcomes were reported. Important outcomes including DFS and OS are included at updated in subsequent publications. Quality of life was collected (as per conference abstract) but not yet reported.
Incomplete outcome data (attrition bias) All outcomes	Low risk	Intention‐to‐treat analysis performed – all participants who were randomised were included in the analysis.
Other bias	Low risk	None identified.

AUC: area under the curve; BRCA: breast cancer gene; CALGB: Cancer and Leukemia Group B; CTCAE: Common Terminology Criteria for Adverse Events; DFS: disease‐free survival; ECOG: Eastern Cooperative Oncology Group; EFS: event‐free survival; EORTC QLQ‐BR23: European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire – Breast Cancer; EORTC QLQ‐C30: European Organisation for Research and Treatment of Cancer Quality of Life of Cancer Patient; EQ‐5D 5L: 5‐level Euroqol EQ‐5D; FACT‐An: Functional Assessment of Cancer Therapy – Anaemia; HRD: homologous recombination deficiency; MRI: magnetic resonance imaging; NCI CTC: National Cancer Institute Common Toxicity Criteria; NCI: National Cancer Institute; OS: overall survival; pCR: pathological complete response; RCB: residual cancer burden; RCT: randomised controlled trial; RECIST: Response Evaluation Criteria in Solid Tumors Criteria; RFS: recurrence‐free survival; TNBC: triple‐negative breast cancer.