Long 2006.

Methods	Randomised Phase III trial 1999 to 2001
Participants	186 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 Arm 3: methotrexate 30 mg/m2 iv d1, 15, 22, vinblastine 3 mg/m2 iv d2, 15, 22, doxorubicin 30 mg/m2 iv d2, cisplatin 70 mg/m2 iv d2 q28 Maximum 6 cycles given unless maximum cumulative dose of doxorubicin achieved or progressive disease or unacceptable toxicity
Outcomes	Response rates Toxicity OS
Notes	6 patients ineligible (1 clerical error, 2 wrong cell type, 1 wrong primary, 1 inadequate pathology tissue, 1 second primary tumour. ITT analysis performed This paper reports the third arm of trial reported by Long 2006
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 randomly assigned patients
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	6 patients excluded balanced across arms. ITT analysis
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