{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T04:11:00Z","timestamp":1765080660117,"version":"3.46.0"},"reference-count":10,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T00:00:00Z","timestamp":1685404800000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,4,23]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The rapid evolution of the therapeutic landscape in oncology poses challenges to optimal treatment sequencing. Evidence for clinical decision-making is often limited to studies focused on treatment evaluation at a single decision point, with limited capability of identifying delayed effects of prior treatment decisions on the efficacy and feasibility of future treatments. There is a growing interest in dynamic treatment regimes (DTRs) evaluation as it provides guidance on treatment individualisation based on evolving treatment and patient characteristics. In this scoping review we aim to systematically map how and to what extent DTRs have been evaluated in clinical studies to generate evidence for clinical decision-making in oncology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will do a systematic literature search in MEDLINE (PubMed), Web of Science, Scopus and WHO international clinical trials registry platform to identify clinical studies (including protocols of ongoing studies), with either experimental or observational design, that aim to answer a clinical question and explore treatment sequencing issues in oncology using the concept of DTR. Data extraction will comprise information concerning cancer disease, clinical setting, treatments, tailoring variables, decision rules, decision points and outcomes, type of data, study design and statistical methods used for DTR evaluation. The review will be conducted according to Joanna Briggs Institute Reviewer\u2019s manual for scoping reviews. No patients will be involved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics committee approval is not required as this scoping review will undertake secondary analysis of published literature. Results will be disseminated through a peer-reviewed scientific journal and presented in relevant conferences. This scoping review will provide a better understanding of the methods used to generate evidence on treatment sequencing in oncology and will contribute to the identification of knowledge and methodological gaps that should be addressed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-067192","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T11:00:18Z","timestamp":1685444418000},"page":"e067192","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic treatment regimes (DTRs) to study treatment sequencing in oncology: a scoping review protocol"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8779-8665","authenticated-orcid":false,"given":"Susana","family":"Esteves","sequence":"first","affiliation":[{"name":"Unidade de Investiga\u00e7\u00e3o Cl\u00ednica, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal"},{"name":"Faculdade de Medicina, Universidade do Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1248-4631","authenticated-orcid":false,"given":"Jo\u00e3o Miguel","family":"Alves","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade do Porto, Porto, Portugal"}]},{"given":"Pedro Pereira","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade do Porto, Porto, Portugal"}]},{"given":"Maria","family":"Gomes da Silva","sequence":"additional","affiliation":[{"name":"Departamento de Hematologia, Instituto Portugu\u00eas de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal"}]}],"member":"239","published-online":{"date-parts":[[2023,5,30]]},"reference":[{"key":"2025120618343738000_13.5.e067192.1","doi-asserted-by":"crossref","unstructured":"Thall PF . Chapter 4: SMART design, conduct, and analysis in oncology. In: adaptive treatment strategies in practice. In: Society for Industrial and Applied Mathematics. 2015: 41\u201354. doi:10.1137\/1.9781611974188","DOI":"10.1137\/1.9781611974188.ch4"},{"key":"2025120618343738000_13.5.e067192.2","unstructured":"Tsiatis AA , Davidian M , Holloway ST , et al . Chapter 1. In: Dynamic Treatment Regimes Statistical Methods for Precision Medicine. First. Boca Raton CRC Press: Taylor & Francis Group, 2021: 7\u201311."},{"key":"2025120618343738000_13.5.e067192.3","doi-asserted-by":"crossref","unstructured":"Kidwell KM . Chapter 2: Dtrs and Smarts: definitions, designs, and applications. In: Adaptive Treatment Strategies in Practice. Society for Industrial and Applied Mathematics. 2015: 7\u201323. doi:10.1137\/1.9781611974188","DOI":"10.1137\/1.9781611974188.ch2"},{"key":"2025120618343738000_13.5.e067192.4","doi-asserted-by":"crossref","unstructured":"Mahar RK , McGuinness MB , Chakraborty B , et al . A Scoping review of studies using observational data to Optimise dynamic treatment regimens. BMC Med Res Methodol 2021;21. doi:10.1186\/s12874-021-01211-2 Available: https:\/\/pubmed.ncbi.nlm.nih.gov\/33618655\/","DOI":"10.1186\/s12874-021-01211-2"},{"key":"2025120618343738000_13.5.e067192.5","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.jclinepi.2021.11.007","article-title":"Sequential multiple assignment randomized trial studies should report all key components: a systematic review","volume":"142","author":"Bigirumurame","year":"2022","journal-title":"J Clin Epidemiol"},{"key":"2025120618343738000_13.5.e067192.6","unstructured":"S\u00e9bastien B , Cl\u00e9mence L , Pirrachio Romain VS . Are marginal structural models appropriately used and reported in the medical literature? A systematic review Crd42018083822. PROSPERO. 2018. Available: https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42018083822"},{"key":"2025120618343738000_13.5.e067192.7","unstructured":"MZ AE , ed. JBI manual for evidence synthesis. JBI. 2020. 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