Estimands and their implications for evidence synthesis for oncology: A simulation study of treatment switching in meta-analysis.

ABSTRACT: The ICH E9(R1) addendum provides guidelines on accounting for intercurrent events in clinical trials using the estimands framework. However, there has been limited attention to the estimands framework for meta-analysis. Using treatment switching, a well-known intercurrent event that occurs frequently in oncology, we conducted a simulation study to explore the bias introduced by pooling together estimates targeting different estimands in a meta-analysis of randomized clinical trials (RCTs) that allowed treatment switching. We simulated overall survival data of a collection of RCTs that allowed patients in the control group to switch to the intervention treatment after disease progression under fixed effects and random effects models. For each RCT, we calculated effect estimates for a treatm

SUBMITTER: Metcalfe RK 

PROVIDER: S-EPMC12824772 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature