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Trial sequential analysis of progression-free survival (A) and overall survival (B) of adding immune checkpoint inhibitors to standard chemotherapy or chemoradiotherapy for advanced or recurrent cervical cancer. Red inward-sloping line to the left represents trial sequential monitoring boundary. Blue line represents evolution of cumulative Z-score. Horizontal green lines represent the conventional boundaries for statistical significance. Horizontal orange lines represent the null line. Heterogeneity-adjusted a priori information size <t>(APIS)</t> to demonstrate or reject 15% relative risk reduction (RRR) of mortality risk (with a two-sided alpha of 5% and a statistical power of 80%) is 1990 patients <t>for</t> <t>PFS</t> and OS (vertical red line). Cumulative Z-curve crossing the trial sequential monitoring boundary or the APIS boundary provides firm evidence of effect.
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Trial sequential analysis of progression-free survival (A) and overall survival (B) of adding immune checkpoint inhibitors to standard chemotherapy or chemoradiotherapy for advanced or recurrent cervical cancer. Red inward-sloping line to the left represents trial sequential monitoring boundary. Blue line represents evolution of cumulative Z-score. Horizontal green lines represent the conventional boundaries for statistical significance. Horizontal orange lines represent the null line. Heterogeneity-adjusted a priori information size <t>(APIS)</t> to demonstrate or reject 15% relative risk reduction (RRR) of mortality risk (with a two-sided alpha of 5% and a statistical power of 80%) is 1990 patients <t>for</t> <t>PFS</t> and OS (vertical red line). Cumulative Z-curve crossing the trial sequential monitoring boundary or the APIS boundary provides firm evidence of effect.
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Trial sequential analysis of progression-free survival (A) and overall survival (B) of adding immune checkpoint inhibitors to standard chemotherapy or chemoradiotherapy for advanced or recurrent cervical cancer. Red inward-sloping line to the left represents trial sequential monitoring boundary. Blue line represents evolution of cumulative Z-score. Horizontal green lines represent the conventional boundaries for statistical significance. Horizontal orange lines represent the null line. Heterogeneity-adjusted a priori information size (APIS) to demonstrate or reject 15% relative risk reduction (RRR) of mortality risk (with a two-sided alpha of 5% and a statistical power of 80%) is 1990 patients for PFS and OS (vertical red line). Cumulative Z-curve crossing the trial sequential monitoring boundary or the APIS boundary provides firm evidence of effect.

Journal: Frontiers in Immunology

Article Title: Efficacy and safety of adding immune checkpoint inhibitors to standard chemotherapy or chemoradiotherapy for advanced or recurrent cervical cancer: a meta-analysis

doi: 10.3389/fimmu.2026.1780791

Figure Lengend Snippet: Trial sequential analysis of progression-free survival (A) and overall survival (B) of adding immune checkpoint inhibitors to standard chemotherapy or chemoradiotherapy for advanced or recurrent cervical cancer. Red inward-sloping line to the left represents trial sequential monitoring boundary. Blue line represents evolution of cumulative Z-score. Horizontal green lines represent the conventional boundaries for statistical significance. Horizontal orange lines represent the null line. Heterogeneity-adjusted a priori information size (APIS) to demonstrate or reject 15% relative risk reduction (RRR) of mortality risk (with a two-sided alpha of 5% and a statistical power of 80%) is 1990 patients for PFS and OS (vertical red line). Cumulative Z-curve crossing the trial sequential monitoring boundary or the APIS boundary provides firm evidence of effect.

Article Snippet: Time-to-event endpoints (PFS and OS) were evaluated using an a priori information size (APIS) framework implemented in Stata 12.0 and R 4.3.2, whereas dichotomous outcomes were assessed with TSA software v0.9.5.10 Beta to estimate the required information size (RIS) and to construct trial sequential monitoring boundaries.

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