November 15, 2017 In the case of discontinuation of chemotherapy due to toxic effects, antibody therapy was continued until disease progression, the advancement of unacceptable toxic results, or withdrawal of consent. All medicines intravenously were administered. Assessments Routine tumor assessments, predicated on RECIST, were performed every 9 weeks by the investigator and by personnel at the independent review facility; these assessments were performed before period of assessed disease progression or death independently. Decisions regarding treatment had been created by the investigator, exclusively based on the investigator’s evaluation of disease progression. Assessments of left ventricular ejection fraction were performed at baseline, every 9 weeks through the treatment period, at the right time of discontinuation of treatment, every 6 months in the initial year after discontinuation, and annually thereafter for up to 3 years.Therefore, the process was subsequently revised to make viability testing optional also to allow the use of either SPECT or dobutamine echocardiography for viability screening. Investigators at all research centers were highly encouraged to perform viability testing in every patient, but the decision to perform the test was left up to the recruiting investigators. Therefore, just a subgroup of individuals in the hypothesis 1 element of the trial underwent viability tests. Details regarding the collection of individuals for imaging are defined in the Supplementary Appendix. Independent core laboratories that were funded by the National Heart, Lung, and Bloodstream Institute where investigators were unaware of study-group assignments and the individual characteristics of individuals coordinated data collection and evaluation for the SPECT and dobutamine echocardiography studies.