Pannuti 1984.

Study characteristics
Methods	Accrual dates: not reported Sample size: 46 Randomisation method not reported Baseline comparability: no significant imbalance apparent or reported
Participants	Female 100% MBC (87% with metastases of bone or viscera) Unclear if prior chemotherapy received by 17% was for MBC Age range: 36‐74 years Median age: 55 (both arms)
Interventions	CMF vs R14 Arm I: (CMF) cyclophosphamide + methotrexate + 5‐fluorouracil Arm II: (R14) arm I + vincristine + vinblastine + doxorubicin
Outcomes	Overall survival Response (defined as ≥ 50% reduction in tumour size) Toxicity
Notes	46/46 included in analysis Follow‐up details not reported: ‐estimated minimum follow‐up 5.5 months ‐estimated maximum follow‐up 45 months (from survival curve) Time‐to‐event data extracted directly from time‐to‐event curve. Treatment related deaths not reported. Doses of the same chemotherapy agent are markedly different between treatment arms.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	B ‐ Unclear
Allocation concealment (selection bias)	Unclear risk	B ‐ Unclear
Blinding (performance bias and detection bias) All outcomes	Unclear risk	B ‐ Unclear
Incomplete outcome data (attrition bias) Response	Low risk	A ‐ Adequate
Incomplete outcome data (attrition bias) Toxicity	Low risk	A ‐ Adequate
Incomplete outcome data (attrition bias) Overall survival	Unclear risk	B ‐ Unclear
Selective reporting (reporting bias)	Low risk	A ‐ Adequate, outcomes reported
Other bias	High risk	C ‐ Inadequate, higher proportion of R14 group premenopausal, small study groups