Gundersen S 1986.

Study characteristics
Methods	Accrual (June 1982‐ December 1983) RCT ‐ Allocation by random number generation ‐ no stratification Norway ‐ multi‐centre Groups well balanced according to age, disease free interval and time from first metastases to randomisation
Participants	128 women with metastatic BC, histologically proven with evaluable lesions Those previously treated with Adriamycin were excluded ‐ all were hormone resistant‐ 100% MBC 100% Firstline Randomised no: 1) n = 62 (Mean age 59) 2) n = 66 (Mean age 56)
Interventions	A vs V1+A+C 1) Doxorubicin 20 mg/week to max dose 750 mg/m2 2) Vincristine 2 mg + Adriamycin 50 mg/m2 to max dose 500 mg/m2 + Cyclophosphamide 600 mg/m2 (VAC every 3 weeks)
Outcomes	Overall survival curves calculated by actuarial life table method ‐ survival calculated from start of treatment No TTP curves Mean TTF 1) 33 mths 2) 29mths OR (CR+PR) 1) 19/62 2) 24/66 Toxicity WHO 3 Vomiting 1) 4/62 2) 43/66 Alopecia 1) 5/62 2) 52/66 Toxic death ‐ NR
Notes	F/U min 3mths (based on first assessment of response or review of treatment)‐ max 24mths (from survival curve ITT ‐
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Allocation by random number generation
Allocation concealment (selection bias)	Low risk	Not reported
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data
Selective reporting (reporting bias)	Low risk	All expected outcomes reported