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Statistics — SCE Medical Oncology MCQ

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HardClinical Trials & StatisticsStatisticsSCE Medical Oncology

A randomised oncology trial improves progression-free survival, but intention-to-treat overall survival is similar because 70% of control patients receive the active drug after progression. Which sensitivity analysis most directly addresses this treatment-switching dilution?

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Correct answer: A — Rank-preserving structural failure-time analysis

High crossover can dilute the intention-to-treat OS contrast. Structural treatment-switching methods such as an RPSFT analysis can estimate a counterfactual no-switch effect under explicit assumptions. Deleting switchers, responder-only analysis and naive censoring introduce selection or informative-censoring bias; response rate does not answer the OS question.

Reference: Treatment switching and overall survival in oncology trials. https://pubmed.ncbi.nlm.nih.gov/30227487/