Long 2005.

Methods	Randomised Phase III trial 1999 to 2002
Participants	294 women with histologically confirmed advanced (Stage IVb), recurrent or persistent squamous cell, adenocarcinoma or adenosquamous cervical cancer unsuitable for curative treatment with surgery or radiotherapy, or both
Interventions	Arm 1: cisplatin 50 mg/m2 iv d1 q21 Arm 2: cisplatin 50 mg/m2 iv d1 and topotecan 0.75 mg/m2 iv d1‐3 q21
Outcomes	Response rates Toxicity OS
Notes	8 patients excluded (1 institutional review board approval error, 2 second active malignancy present, 2 wrong histological type, 1 primary tumour other than cervical cancer, 2 inadequate tissue to confirm metastases). ITT analysis performed Trial originally had 3 arms but third arm (MVAC) was closed early owing to toxicity and is reported in detail in separate papers
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Patients assigned with equal probability using a fixed‐block design
Allocation concealment (selection bias)	Low risk	GOG Statistical and Data Centre performed randomisation
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not documented but OS unlikely to be affected by blinding
Incomplete outcome data (attrition bias) All outcomes	Low risk	8 patients excluded but balanced across groups. ITT analysis performed
Selective reporting (reporting bias)	Low risk	Published report included all pre‐specified outcomes
Other bias	Unclear risk	MVAC arm closed early owing to toxic deaths