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melanoma (ML), 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) 0.70 [0.61, 0.80]< 157%12 studies (12/-)100.0 %lowlow highcrucial-
deaths (OS) (extension) 0.65 [0.54, 0.78]< 169%5 studies (5/-)100.0 %lownot evaluable highimportant-
MFS 0.64 [0.47, 0.87]< 148%2 studies (2/-)99.8 %lownot evaluable highimportant-
PFS (extension) 0.58 [0.48, 0.70]< 177%5 studies (5/-)100.0 %lownot evaluable highimportant-
progression or deaths (PFS) 0.61 [0.52, 0.72]< 179%11 studies (11/-)100.0 %lowlow highimportant-
RFS (extension) 0.63 [0.50, 0.80]< 169%2 studies (2/-)100.0 %lownot evaluable highimportant-
RFS/DFS 0.59 [0.50, 0.70]< 10%4 studies (4/-)100.0 %lownot evaluable highimportant-
DCR 0.91 [0.63, 1.32]> 10%1 study (1/-)31.6 %NAnot evaluable non important-
DMFS 0.60 [0.49, 0.73]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
DOR 0.41 [0.20, 0.83]< 10%1 study (1/-)99.3 %NAnot evaluable non important-
DOR (extension) 3.45 [1.46, 8.18]> 10%1 study (1/-)99.8 %NAnot evaluable non important-
objective responses (ORR) 2.58 [1.68, 3.97]> 189%11 studies (11/-)100.0 %lowlow highnon important-
objective responses (ORR) (extension) 4.57 [3.31, 6.32]> 150%3 studies (3/-)100.0 %lownot evaluable highnon important-

safety endpoints 00

AE (any grade) 1.49 [0.61, 3.64]< 176%5 studies (5/-)18.9 %lownot evaluable highnon important-
AE (grade 3-4) 1.34 [0.47, 3.82]< 197%5 studies (5/-)29.0 %lownot evaluable highnon important-
AE leading to death (grade 5) 1.34 [0.65, 2.76]< 10%6 studies (6/-)21.2 %lownot evaluable highnon important-
AE leading to treatment discontinuation (any grade) 1.28 [0.36, 4.56]< 195%6 studies (6/-)35.3 %lowserious highnon important-
AE leading to treatment discontinuation (grade 3-4) 1.26 [0.15, 10.80]< 196%4 studies (4/-)41.7 %lownot evaluable highnon important-
SAE (any grade) 1.45 [0.55, 3.84]< 185%3 studies (3/-)22.7 %lownot evaluable highnon important-
SAE (grade 3-4) 1.77 [0.60, 5.28]< 185%3 studies (3/-)15.2 %lownot evaluable highnon important-
STRAE (any grade) 1.36 [0.75, 2.47]< 182%6 studies (6/-)15.2 %lownot evaluable highnon important-
STRAE (grade 3-4) 2.45 [0.78, 7.74]< 155%5 studies (5/-)6.3 %lownot evaluable highnon important-
TRAE (any grade) 1.21 [0.81, 1.80]< 185%13 studies (13/-)17.8 %lowlow highnon important-
TRAE (grade 3-4) 1.32 [0.70, 2.51]< 196%13 studies (13/-)19.4 %lowlow highnon important-
TRAE leading to death (grade 5) 1.09 [0.37, 3.25]< 10%11 studies (11/-)43.9 %lowlow highnon important-
TRAE leading to discontinuation (any grade) 1.50 [0.57, 3.95]< 196%10 studies (10/-)20.4 %lowlow highnon important-
TRAE leading to discontinuation (grade 3-4) 1.60 [0.40, 6.41]< 195%9 studies (9/-)25.5 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.77 [0.21, 2.78]< 10%8 studies (8/-)65.7 %lownot evaluable highnon important-
Acute kidney injury TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 1.45 [0.57, 3.70]< 10%6 studies (6/-)21.9 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 0.95 [0.22, 4.21]< 10%7 studies (7/-)52.5 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 0.39 [0.12, 1.24]< 18%7 studies (7/-)94.5 %some concernnot evaluable moderatenon important-
Arthralgia TRAE (grade 3-4) 1.30 [0.64, 2.62]< 10%12 studies (12/-)23.4 %lowlow highnon important-
Asthenia TRAE (grade 3-4) 0.73 [0.32, 1.67]< 10%9 studies (9/-)77.0 %lownot evaluable highnon important-
Blood and lymphatic system disorders TRAE (grade 3-4) 3.02 [0.28, 33.13]< 10%2 studies (2/-)18.5 %lownot evaluable highnon important-
Blood creatinine increased TRAE (grade 3-4) 0.72 [0.06, 9.49]< 10%2 studies (2/-)59.7 %lownot evaluable highnon important-
Chills TRAE (grade 3-4) 0.94 [0.13, 6.73]< 10%4 studies (4/-)52.4 %some concernnot evaluable moderatenon important-
Chorioretinopathy TRAE (grade 3-4) 0.61 [0.02, 18.27]< 10%1 study (1/-)61.1 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 1.09 [0.30, 3.99]< 182%9 studies (9/-)44.6 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 0.95 [0.16, 5.50]< 10%5 studies (5/-)52.2 %some concernnot evaluable moderatenon important-
Cough TRAE (grade 3-4) 0.97 [0.25, 3.82]< 10%7 studies (7/-)51.8 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 1.05 [0.33, 3.30]< 10%10 studies (10/-)46.8 %lowlow highnon important-
Diabetes TRAE (grade 3-4) 2.27 [0.52, 9.86]< 10%5 studies (5/-)13.8 %lowserious highnon important-
Diarrhoea TRAE (grade 3-4) 0.76 [0.35, 1.62]< 169%12 studies (12/-)76.4 %lowlow highnon important-
Dizziness TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 1.23 [0.37, 4.12]< 10%10 studies (10/-)36.7 %lowcritical highnon important-
Dysgeusia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dyspepsia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dyspnoea TRAE (grade 3-4) 1.42 [0.43, 4.65]< 10%7 studies (7/-)28.1 %lownot evaluable highnon important-
Endocrine disorders TRAE (grade 3-4) 6.23 [1.33, 29.21]< 10%3 studies (3/-)1.0 %lownot evaluable highnon important-
Erythema TRAE (grade 3-4) 7.41 [0.37, 148.78]< 10%1 study (1/-)9.8 %NAnot evaluable non important-
Eye disorders TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Fatigue TRAE (grade 3-4) 0.76 [0.37, 1.58]< 135%11 studies (11/-)77.0 %lowlow highnon important-
Gastritis TRAE (grade 3-4) 2.32 [0.20, 26.84]< 10%2 studies (2/-)25.1 %lownot evaluable highnon important-
Gastrointestinal disorders TRAE (grade 3-4) 1.57 [0.10, 24.07]< 191%4 studies (4/-)37.4 %lownot evaluable highnon important-
General disorders and administration site conditions TRAE (grade 3-4) 2.32 [0.20, 26.84]< 10%2 studies (2/-)25.1 %lownot evaluable highnon important-
Headache TRAE (grade 3-4) 0.60 [0.19, 1.92]< 10%8 studies (8/-)80.4 %lowserious highnon important-
Hepatitis TRAE (grade 3-4) 3.83 [1.67, 8.76]< 10%9 studies (9/-)0.1 %lownot evaluable highnon important-
Hepatobiliary disorders TRAE (grade 3-4) 1.42 [0.07, 29.90]< 191%3 studies (3/-)41.2 %lownot evaluable highnon important-
Hypersensitivity TRAE (grade 3-4) 1.49 [0.11, 19.39]< 10%2 studies (2/-)38.2 %lownot evaluable highnon important-
Hypertension TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 1.67 [0.63, 4.40]< 10%12 studies (12/-)15.1 %lowlow highnon important-
Hypophysitis TRAE (grade 3-4) 0.67 [0.27, 1.64]< 117%10 studies (10/-)81.1 %lowlow highnon important-
Hypothyroidism TRAE (grade 3-4) 0.97 [0.33, 2.85]< 10%11 studies (11/-)52.0 %lowlow highnon important-
Increase AST TRAE (grade 3-4) 1.14 [0.33, 3.90]< 169%8 studies (8/-)41.9 %lownot evaluable highnon important-
Increased ALT TRAE (grade 3-4) 1.32 [0.37, 4.69]< 179%8 studies (8/-)33.6 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 1.47 [0.89, 2.43]< 148%5 studies (5/-)6.7 %lownot evaluable highnon important-
Infusion-related reactions TRAE (grade 3-4) 0.97 [0.10, 9.43]< 10%3 studies (3/-)50.9 %lownot evaluable highnon important-
Leucopenia TRAE (grade 3-4) 0.16 [0.04, 0.65]< 10%5 studies (5/-)99.4 %lowserious highnon important-
Maculopapular rash TRAE (grade 3-4) 1.34 [0.84, 2.14]< 10%11 studies (11/-)11.1 %lowlow highnon important-
Metabolism and nutrition disorders TRAE (grade 3-4) 1.29 [0.15, 11.24]< 10%2 studies (2/-)40.9 %lownot evaluable highnon important-
Musculoskeletal and connective tissue disorders TRAE (grade 3-4) 0.96 [0.03, 31.61]< 163%2 studies (2/-)50.8 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 1.18 [0.45, 3.05]< 10%10 studies (10/-)36.9 %lowcritical highnon important-
Myocarditis TRAE (grade 3-4) 1.97 [0.07, 58.99]< 10%1 study (1/-)34.9 %NAnot evaluable non important-
Myositis TRAE (grade 3-4) 0.95 [0.16, 5.51]< 10%5 studies (5/-)52.2 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 0.56 [0.23, 1.37]< 10%12 studies (12/-)89.8 %lowlow highnon important-
Nephritis TRAE (grade 3-4) 1.03 [0.15, 6.90]< 10%3 studies (3/-)48.7 %some concernnot evaluable moderatenon important-
Nervous system disorders TRAE (grade 3-4) 1.07 [0.16, 7.27]< 10%2 studies (2/-)47.3 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.20 [0.06, 0.72]< 10%7 studies (7/-)99.3 %some concernserious moderatenon important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Pancreatitis TRAE (grade 3-4) 1.12 [0.24, 5.34]< 10%5 studies (5/-)44.3 %lownot evaluable highnon important-
Pancytopenia TRAE (grade 3-4) 0.16 [0.01, 3.29]< 10%1 study (1/-)87.9 %NAnot evaluable non important-
Paraesthesia TRAE (grade 3-4) 0.75 [0.18, 3.09]< 10%7 studies (7/-)65.6 %some concernserious moderatenon important-
Peripheral neuropathy TRAE (grade 3-4) 0.51 [0.10, 2.70]< 10%4 studies (4/-)78.6 %some concernnot evaluable moderatenon important-
Peripheral oedema TRAE (grade 3-4) 1.22 [0.02, 61.84]< 10%1 study (1/-)46.1 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 2.07 [0.79, 5.39]< 10%10 studies (10/-)6.9 %lowlow highnon important-
Pruritic rash TRAE (grade 3-4) 0.96 [0.13, 6.82]< 10%4 studies (4/-)51.7 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 1.31 [0.52, 3.29]< 10%12 studies (12/-)28.2 %lowlow highnon important-
Pyrexia TRAE (grade 3-4) 1.09 [0.41, 2.86]< 10%9 studies (9/-)43.4 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 0.86 [0.44, 1.66]< 118%10 studies (10/-)67.6 %lowlow highnon important-
Renal and urinary disorders TRAE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 0.98 [0.15, 6.59]< 122%4 studies (4/-)50.8 %lownot evaluable highnon important-
Sarcoidosis TRAE (grade 3-4) 0.97 [0.10, 9.40]< 10%3 studies (3/-)51.0 %lownot evaluable highnon important-
Severe skin reaction TRAE (grade 3-4) 5.95 [0.30, 119.02]< 10%1 study (1/-)12.5 %NAnot evaluable non important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 0.85 [0.14, 5.17]< 159%4 studies (4/-)57.0 %lownot evaluable highnon important-
Stomatitis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 0.23 [0.06, 0.85]< 10%5 studies (5/-)98.6 %some concernnot evaluable moderatenon important-
Thyroiditis TRAE (grade 3-4) 1.17 [0.21, 6.41]< 10%5 studies (5/-)42.9 %lowserious 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.