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breast cancer - triple negative, anti-PD-(L)1 , meta-analysis of study results

Outcome Relative effect 95%CI LoD Trt. better when I2 k (RCT/OBS) Bayesian probability Overall ROB Publication bias Degree of certainty Endpoint importance Published MA

efficacy endpoints 00

deaths (OS) 0.88 [0.81, 0.97]< 10%5 studies (5/-)99.6 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.24 [0.03, 2.28]< 10%1 study (1/-)89.2 %NAnot evaluable important-
PFS (extension) 0.80 [0.69, 0.92]< 10%1 study (1/-)99.9 %NAnot evaluable important-
progression or deaths (PFS) 0.92 [0.64, 1.31]< 193%4 studies (4/-)68.1 %lownot evaluable highimportant-
DCR 0.60 [0.39, 0.94]> 10%1 study (1/-)1.3 %NAnot evaluable non important-
DOR 0.78 [0.63, 0.97]< 10%1 study (1/-)98.6 %NAnot evaluable non important-
events or deaths (EFS) 0.66 [0.48, 0.92]< 10%2 studies (2/-)99.3 %lownot evaluable highnon important-
objective responses (ORR) 0.85 [0.31, 2.31]> 197%4 studies (4/-)37.2 %lownot evaluable highnon important-
pCR 3.30 [0.99, 11.04]> 193%3 studies (3/-)97.4 %lownot evaluable highnon important-

safety endpoints 00

AE (any grade) 1.47 [0.63, 3.40]< 15%4 studies (4/-)18.6 %lownot evaluable highnon important-
AE (grade 3-4) 1.28 [1.09, 1.50]< 10%4 studies (4/-)0.1 %lownot evaluable highnon important-
AE leading to death (grade 5) 1.61 [0.49, 5.27]< 10%3 studies (3/-)21.7 %lownot evaluable highnon important-
AE leading to treatment discontinuation (any grade) 1.66 [0.89, 3.11]< 171%2 studies (2/-)5.6 %lownot evaluable highnon important-
SAE (any grade) 1.25 [0.91, 1.70]< 148%4 studies (4/-)8.1 %lownot evaluable highnon important-
STRAE (any grade) 1.72 [1.21, 2.45]< 10%2 studies (2/-)0.1 %lownot evaluable highnon important-
TRAE (any grade) 1.38 [0.84, 2.27]< 111%4 studies (4/-)10.3 %lownot evaluable highnon important-
TRAE (grade 3-4) 0.93 [0.56, 1.56]< 192%5 studies (5/-)60.3 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 1.13 [0.51, 2.49]< 10%4 studies (4/-)38.0 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 1.72 [0.89, 3.31]< 152%2 studies (2/-)5.4 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.94 [0.06, 15.18]< 10%1 study (1/-)51.6 %NAnot evaluable non important-
Acute kidney injury TRAE (grade 3-4) 0.47 [0.02, 14.11]< 10%1 study (1/-)66.5 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 3.47 [0.52, 23.34]< 10%3 studies (3/-)10.2 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 0.86 [0.41, 1.80]< 10%3 studies (3/-)65.4 %lownot evaluable highnon important-
Anaemia TRAE (grade 3-4) 1.03 [0.65, 1.65]< 160%3 studies (3/-)44.8 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 1.37 [0.69, 2.72]< 10%2 studies (2/-)18.6 %lownot evaluable highnon important-
Colitis TRAE (grade 3-4) 2.02 [0.49, 8.26]< 10%4 studies (4/-)16.5 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 0.48 [0.04, 6.30]< 10%2 studies (2/-)70.9 %some concernnot evaluable moderatenon important-
Cough TRAE (grade 3-4) 1.89 [0.06, 56.64]< 10%1 study (1/-)35.8 %NAnot evaluable non important-
Decreased appetite TRAE (grade 3-4) 2.02 [0.34, 12.03]< 10%2 studies (2/-)22.2 %lownot evaluable highnon important-
Diabetes TRAE (grade 3-4) 1.25 [0.20, 7.77]< 10%3 studies (3/-)40.7 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 0.69 [0.10, 4.85]< 178%2 studies (2/-)64.5 %lownot evaluable highnon important-
Dysgeusia TRAE (grade 3-4) 0.50 [0.01, 25.13]< 10%1 study (1/-)63.4 %NAnot evaluable non important-
Dyspnoea TRAE (grade 3-4) 1.89 [0.06, 56.64]< 10%1 study (1/-)35.8 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 1.51 [0.84, 2.72]< 10%3 studies (3/-)8.6 %lownot evaluable highnon important-
Febrile neutropenia TRAE (grade 3-4) 0.31 [0.01, 6.85]< 179%2 studies (2/-)76.6 %lownot evaluable highnon important-
Guillain-Barré syndrome TRAE (grade 3-4) 0.51 [0.02, 15.24]< 10%1 study (1/-)65.0 %NAnot evaluable non important-
Headache TRAE (grade 3-4) 1.89 [0.06, 56.64]< 10%1 study (1/-)35.8 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 4.26 [0.42, 42.77]< 10%2 studies (2/-)11.1 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 1.24 [0.21, 7.26]< 10%4 studies (4/-)40.6 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 8.04 [0.46, 140.38]< 10%1 study (1/-)7.9 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 1.98 [0.38, 10.33]< 10%4 studies (4/-)20.9 %lownot evaluable highnon important-
Increase AST TRAE (grade 3-4) 3.49 [0.75, 16.21]< 145%2 studies (2/-)5.6 %some concernnot evaluable moderatenon important-
Increased ALT TRAE (grade 3-4) 1.69 [1.05, 2.73]< 10%3 studies (3/-)1.6 %lownot evaluable highnon important-
Infusion-related reactions TRAE (grade 3-4) 2.24 [0.82, 6.15]< 10%2 studies (2/-)5.8 %lownot evaluable highnon important-
Leucopenia TRAE (grade 3-4) 0.78 [0.61, 1.00]< 18%3 studies (3/-)97.5 %lownot evaluable highnon important-
Maculopapular rash TRAE (grade 3-4) 1.89 [0.06, 56.64]< 10%1 study (1/-)35.8 %NAnot evaluable non important-
Myalgia TRAE (grade 3-4) 0.47 [0.02, 14.11]< 10%1 study (1/-)66.5 %NAnot evaluable non important-
Myocarditis TRAE (grade 3-4) 1.99 [0.09, 44.34]< 10%1 study (1/-)33.3 %NAnot evaluable non important-
Myositis TRAE (grade 3-4) 2.23 [0.32, 15.67]< 10%3 studies (3/-)21.2 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 1.77 [0.85, 3.67]< 10%3 studies (3/-)6.4 %lownot evaluable highnon important-
Nephritis TRAE (grade 3-4) 3.49 [0.34, 35.41]< 10%2 studies (2/-)14.7 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.81 [0.42, 1.55]< 183%3 studies (3/-)74.1 %lownot evaluable highnon important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.13 [0.02, 1.08]< 10%1 study (1/-)97.0 %NAnot evaluable non important-
Pancreatitis TRAE (grade 3-4) 4.00 [0.21, 75.85]< 10%1 study (1/-)18.1 %NAnot evaluable non important-
Pancytopenia TRAE (grade 3-4) 0.24 [0.01, 5.23]< 10%1 study (1/-)81.7 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 1.88 [0.62, 5.72]< 10%1 study (1/-)13.2 %NAnot evaluable non important-
Peripheral sensory neuropathy TRAE (grade 3-4) 0.72 [0.13, 4.06]< 137%2 studies (2/-)64.7 %lownot evaluable highnon important-
Pneumonia TRAE (grade 3-4) 0.24 [0.01, 5.23]< 10%1 study (1/-)81.7 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 2.93 [0.72, 11.83]< 10%4 studies (4/-)6.7 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 1.89 [0.06, 56.64]< 10%1 study (1/-)35.8 %NAnot evaluable non important-
Pyrexia TRAE (grade 3-4) 2.39 [0.45, 12.62]< 10%2 studies (2/-)15.4 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 1.37 [0.49, 3.84]< 12%2 studies (2/-)27.6 %lownot evaluable highnon important-
Sarcoidosis TRAE (grade 3-4) 0.50 [0.01, 25.13]< 10%1 study (1/-)63.4 %NAnot evaluable non important-
Sepsis TRAE (grade 3-4) 0.94 [0.02, 47.78]< 10%1 study (1/-)51.1 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 5.90 [1.64, 21.16]< 10%4 studies (4/-)0.3 %lownot evaluable highnon important-
Stomatitis TRAE (grade 3-4) 2.64 [0.12, 57.65]< 149%2 studies (2/-)27.1 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 0.94 [0.06, 15.18]< 10%1 study (1/-)51.6 %NAnot evaluable non important-
Thyroiditis TRAE (grade 3-4) 1.50 [0.13, 17.05]< 10%2 studies (2/-)37.4 %lownot evaluable highnon important-
Urticaria TRAE (grade 3-4) 1.89 [0.06, 56.64]< 10%1 study (1/-)35.8 %NAnot evaluable non important-
Uveitis TRAE (grade 3-4) 0.50 [0.01, 25.13]< 10%1 study (1/-)63.4 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 1.51 [0.59, 3.82]< 10%1 study (1/-)19.5 %NAnot evaluable non important-
Weight decreased TRAE (grade 3-4) 0.47 [0.04, 5.22]< 10%1 study (1/-)72.9 %NAnot evaluable non important-

AE (grade 3-4) endpoints 00

hepatitis (Autoimmune) AE (grade 3-4) 1.23 [0.14, 10.62]< 10%2 studies (2/-)42.4 %lownot evaluable highnon important-
Abdominal pain AE (grade 3-4) 1.16 [0.20, 6.72]< 10%3 studies (3/-)43.5 %lownot evaluable highnon important-
Acute kidney injury AE (grade 3-4) 1.93 [0.06, 57.72]< 10%1 study (1/-)35.4 %NAnot evaluable non important-
Adrenal insufficiency AE (grade 3-4) 1.93 [0.06, 57.72]< 10%1 study (1/-)35.4 %NAnot evaluable non important-
Alopecia AE (grade 3-4) 1.43 [0.23, 8.79]< 10%3 studies (3/-)35.1 %lownot evaluable highnon important-
Anaemia AE (grade 3-4) 1.10 [0.64, 1.87]< 10%3 studies (3/-)36.6 %lownot evaluable highnon important-
Arthralgia AE (grade 3-4) 1.30 [0.25, 6.81]< 10%3 studies (3/-)37.7 %lownot evaluable highnon important-
Asthenia AE (grade 3-4) 0.98 [0.31, 3.12]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Back pain AE (grade 3-4) 1.90 [0.49, 7.43]< 10%3 studies (3/-)17.8 %lownot evaluable highnon important-
Blood creatinine increased AE (grade 3-4) 0.05 [0.00, 0.89]< 10%1 study (1/-)97.8 %NAnot evaluable non important-
Cardiomyopathy AE (grade 3-4) 1.93 [0.06, 57.72]< 10%1 study (1/-)35.4 %NAnot evaluable non important-
Chills AE (grade 3-4) 1.93 [0.06, 57.72]< 10%1 study (1/-)35.4 %NAnot evaluable non important-
Colitis AE (grade 3-4) 0.96 [0.06, 15.47]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Constipation AE (grade 3-4) 1.39 [0.29, 6.62]< 10%3 studies (3/-)34.1 %lownot evaluable highnon important-
Cough AE (grade 3-4) 0.96 [0.10, 9.23]< 10%3 studies (3/-)51.5 %lownot evaluable highnon important-
Decreased appetite AE (grade 3-4) 0.97 [0.22, 4.30]< 10%2 studies (2/-)51.5 %lownot evaluable highnon important-
Diarrhoea AE (grade 3-4) 1.58 [0.48, 5.16]< 125%3 studies (3/-)22.5 %lownot evaluable highnon important-
Dizziness AE (grade 3-4) 0.96 [0.02, 48.73]< 10%1 study (1/-)50.7 %NAnot evaluable non important-
Dry skin AE (grade 3-4) 1.43 [0.11, 18.75]< 10%2 studies (2/-)39.3 %lownot evaluable highnon important-
Dysgeusia AE (grade 3-4) 0.99 [0.06, 15.89]< 10%2 studies (2/-)50.2 %lownot evaluable highnon important-
Dyspepsia AE (grade 3-4) 1.02 [0.02, 51.63]< 10%1 study (1/-)49.6 %NAnot evaluable non important-
Dysphonia AE (grade 3-4) 1.93 [0.06, 57.72]< 10%1 study (1/-)35.4 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 0.98 [0.30, 3.20]< 10%3 studies (3/-)51.6 %lownot evaluable highnon important-
Epistaxis AE (grade 3-4) 0.95 [0.06, 15.32]< 10%2 studies (2/-)51.4 %lownot evaluable highnon important-
Fatigue AE (grade 3-4) 0.93 [0.54, 1.59]< 10%3 studies (3/-)60.9 %lownot evaluable highnon important-
Febrile neutropenia AE (grade 3-4) 1.32 [0.68, 2.57]< 10%2 studies (2/-)20.6 %lownot evaluable highnon important-
Headache AE (grade 3-4) 0.60 [0.15, 2.42]< 10%3 studies (3/-)76.1 %lownot evaluable highnon important-
Hypertension AE (grade 3-4) 0.59 [0.25, 1.38]< 131%2 studies (2/-)89.0 %lownot evaluable highnon important-

LoD: level of statistical demonstration: Statistically conclusive: statistically significant with a strict control of overall risk of type 1 error (statistically demonstrated), does not take into account the risk of bias; suggested: nominally statistically significant but without a strict control of overall risk of type 1 error; inconclusive: not nominally statistically significant; safety concerns;
Bayesian probability: Bayesian posterior probability of treatment effect (computed with a noninformative prior); ROB: risk of bias; k: number of studies; published MA: number of published meta-analysis on the same topic; degree of certainty adapted from GRADE. Trt. better when: indicates when the relative treatment effect shows that the studied treatment is better than control.