Summary of findings for the main comparison. High‐dose chemotherapy versus chemotherapy without bone marrow transplant or stem cell rescue.
| High‐dose chemotherapy versus chemotherapy without bone marrow transplant or stem cell rescue | ||||||
| Population: women with early poor prognosis breast cancer Setting: Tertiary Intervention: High‐dose chemotherapy Comparison: Chemotherapy without bone marrow transplant or stem cell rescue (standard chemotherapy) | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with standard chemotherapy | Risk with high dose chemotherapy | |||||
| Overall survival at 5‐year follow‐up | 672 per 1000 | 672 per 1000 (645 to 698) | RR 1.00 (0.96 to 1.04) | 3566 (8 RCTs) |
⨁⨁⨁⨁ HIGH | |
| Event‐free survival at 5‐year follow‐up | 578 per 1000 | 601 per 1000 (572 to 630) | RR 1.04 (0.99 to 1.10) | 3566 (8 RCTs) | ⨁⨁⨁⨁ HIGH | |
| Treatment‐related mortality | 2 per 1000 | 14 per 1000 (7 to 28) | RR 7.97 (3.99 to 15.92) | 5600 (14 RCTs) | ⨁⨁⨁⨁ HIGH | Most deaths occurred within the first year of treatment |
| Second cancers at 4 ‐ 9‐year median follow‐up | 25 per 1000 | 31 per 1000 (23 to 43) | RR 1.25 (0.90 to 1.73) | 3423 (7 RCTs) | ⨁⨁⨁⨁ HIGH | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the median risk in the comparison group and the relative effect of the intervention (and its 95% CI) CI: Confidence interval; RR: Risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||