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metastatic/adv melanoma (mML), immune chekpoint inhibitors , 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) 0.73 [0.67, 0.80]< 158%21 studies (21/-)100.0 %lowlow highcrucial-
deaths (OS) (extension) 0.65 [0.57, 0.73]< 166%8 studies (8/-)100.0 %lownot evaluable highimportant-
MFS 0.70 [0.58, 0.84]< 136%3 studies (3/-)100.0 %lownot evaluable highimportant-
MFS (extension) 0.76 [0.64, 0.90]< 10%1 study (1/-)99.9 %NAnot evaluable important-
PFS (extension) 0.53 [0.44, 0.64]< 180%7 studies (7/-)100.0 %lownot evaluable highimportant-
progression or deaths (PFS) 0.61 [0.52, 0.70]< 179%15 studies (15/-)100.0 %lowlow highimportant-
RFS (extension) 0.67 [0.56, 0.80]< 165%3 studies (3/-)100.0 %lownot evaluable highimportant-
RFS/DFS 0.56 [0.44, 0.71]< 167%6 studies (6/-)100.0 %lowserious highimportant-
DCR 1.09 [0.89, 1.33]> 10%3 studies (3/-)79.2 %lownot evaluable highnon important-
DMFS 0.60 [0.49, 0.73]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
DOR 0.59 [0.38, 0.92]< 145%2 studies (2/-)99.0 %lownot evaluable highnon important-
DOR (extension) 3.45 [1.46, 8.18]> 10%1 study (1/-)99.8 %NAnot evaluable non important-
objective responses (ORR) 2.57 [1.76, 3.76]> 190%19 studies (19/-)100.0 %lowlow highnon important-
objective responses (ORR) (extension) 5.31 [3.93, 7.17]> 155%5 studies (5/-)100.0 %lownot evaluable highnon important-

safety endpoints 00

AE (any grade) 2.07 [1.19, 3.60]< 171%11 studies (11/-)0.5 %lowlow highnon important-
AE (grade 3-4) 1.10 [0.56, 2.13]< 197%11 studies (11/-)39.3 %lowlow highnon important-
AE leading to death (grade 5) 1.50 [0.91, 2.46]< 10%9 studies (9/-)5.5 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 2.81 [0.77, 10.28]< 195%8 studies (8/-)5.9 %lowserious highnon important-
AE leading to treatment discontinuation (grade 3-4) 2.55 [0.30, 21.54]< 196%5 studies (5/-)19.6 %lowserious highnon important-
SAE (any grade) 2.14 [0.98, 4.66]< 189%5 studies (5/-)2.8 %lownot evaluable highnon important-
SAE (grade 3-4) 2.63 [0.83, 8.34]< 189%4 studies (4/-)5.1 %lownot evaluable highnon important-
STRAE (any grade) 1.97 [0.97, 3.98]< 188%7 studies (7/-)3.1 %lowserious highnon important-
STRAE (grade 3-4) 4.03 [1.07, 15.21]< 167%6 studies (6/-)2.0 %lownot evaluable highnon important-
TRAE (any grade) 1.87 [1.22, 2.86]< 193%22 studies (22/-)0.2 %lowlow highnon important-
TRAE (grade 3-4) 2.19 [1.29, 3.72]< 196%22 studies (22/-)0.2 %lowcritical highnon important-
TRAE leading to death (grade 5) 1.74 [0.87, 3.49]< 10%17 studies (17/-)5.9 %lowlow highnon important-
TRAE leading to discontinuation (any grade) 2.59 [1.17, 5.72]< 196%15 studies (15/-)0.9 %lowlow highnon important-
TRAE leading to discontinuation (grade 3-4) 2.30 [0.95, 5.56]< 194%13 studies (13/-)3.3 %lowlow highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.64 [0.23, 1.82]< 10%11 studies (11/-)79.8 %lowlow highnon important-
Acute kidney injury TRAE (grade 3-4) 1.59 [0.20, 12.46]< 10%3 studies (3/-)33.0 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 1.58 [0.79, 3.16]< 10%14 studies (14/-)9.7 %lowlow highnon important-
Alopecia TRAE (grade 3-4) 0.95 [0.24, 3.81]< 10%8 studies (8/-)52.8 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 0.45 [0.15, 1.30]< 14%8 studies (8/-)92.9 %some concernnot evaluable moderatenon important-
Arthralgia TRAE (grade 3-4) 1.32 [0.68, 2.56]< 10%15 studies (15/-)21.0 %lowlow highnon important-
Asthenia TRAE (grade 3-4) 0.69 [0.32, 1.49]< 10%11 studies (11/-)82.6 %lowlow highnon important-
Blood and lymphatic system disorders TRAE (grade 3-4) 2.58 [0.36, 18.33]< 10%3 studies (3/-)17.3 %lownot evaluable highnon important-
Blood creatinine increased TRAE (grade 3-4) 0.78 [0.09, 6.72]< 10%3 studies (3/-)58.9 %lownot evaluable highnon important-
Chills TRAE (grade 3-4) 0.84 [0.17, 4.19]< 10%6 studies (6/-)58.3 %lownot evaluable highnon 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) 1.90 [0.91, 3.97]< 178%18 studies (18/-)4.3 %lowlow highnon important-
Constipation TRAE (grade 3-4) 0.96 [0.20, 4.56]< 10%6 studies (6/-)52.2 %some concernnot evaluable moderatenon important-
Cough TRAE (grade 3-4) 0.97 [0.28, 3.31]< 10%9 studies (9/-)52.1 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 1.28 [0.49, 3.33]< 10%13 studies (13/-)30.5 %lowcritical highnon important-
Diabetes TRAE (grade 3-4) 2.03 [0.51, 8.05]< 10%6 studies (6/-)15.7 %lowserious highnon important-
Diarrhoea TRAE (grade 3-4) 1.31 [0.77, 2.23]< 173%21 studies (21/-)15.6 %lowlow highnon important-
Dizziness TRAE (grade 3-4) 0.95 [0.10, 9.23]< 10%3 studies (3/-)51.7 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 1.32 [0.68, 2.53]< 10%12 studies (12/-)20.6 %lowlow highnon important-
Dysgeusia TRAE (grade 3-4) 0.95 [0.10, 9.23]< 10%3 studies (3/-)51.7 %lownot evaluable highnon important-
Dyspepsia TRAE (grade 3-4) 0.95 [0.10, 9.23]< 10%3 studies (3/-)51.7 %lownot evaluable highnon important-
Dyspnoea TRAE (grade 3-4) 1.76 [0.65, 4.80]< 10%10 studies (10/-)13.4 %lowlow highnon important-
Ear and labyrinth disorders TRAE (grade 3-4) 0.97 [0.06, 15.73]< 10%2 studies (2/-)50.8 %lownot evaluable highnon important-
Endocrine disorders TRAE (grade 3-4) 3.45 [1.24, 9.62]< 162%10 studies (10/-)0.9 %lowlow 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) 1.13 [0.23, 5.64]< 10%5 studies (5/-)44.1 %lownot evaluable highnon important-
Fatigue TRAE (grade 3-4) 1.01 [0.50, 2.04]< 142%14 studies (14/-)48.5 %lowlow highnon important-
Febrile neutropenia TRAE (grade 3-4) 3.99 [0.18, 88.89]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Gastritis TRAE (grade 3-4) 2.81 [0.41, 19.25]< 10%3 studies (3/-)14.8 %lownot evaluable highnon important-
Gastrointestinal disorders TRAE (grade 3-4) 3.03 [1.01, 9.08]< 190%11 studies (11/-)2.4 %lowlow highnon important-
General disorders and administration site conditions TRAE (grade 3-4) 2.81 [0.41, 19.25]< 10%3 studies (3/-)14.8 %lownot evaluable highnon important-
Guillain-Barré syndrome TRAE (grade 3-4) 3.99 [0.18, 88.89]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Headache TRAE (grade 3-4) 0.84 [0.32, 2.19]< 10%11 studies (11/-)64.1 %lowlow highnon important-
Hepatitis TRAE (grade 3-4) 3.47 [1.87, 6.43]< 10%18 studies (18/-)0.0 %lowlow highnon important-
Hepatobiliary disorders TRAE (grade 3-4) 2.83 [0.51, 15.67]< 186%9 studies (9/-)11.8 %lowserious highnon important-
Hypersensitivity TRAE (grade 3-4) 2.68 [0.38, 18.88]< 10%3 studies (3/-)16.2 %lownot evaluable highnon important-
Hypertension TRAE (grade 3-4) 0.95 [0.10, 9.23]< 10%3 studies (3/-)51.7 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 1.88 [0.81, 4.36]< 10%16 studies (16/-)7.1 %lowcritical highnon important-
Hypophysitis TRAE (grade 3-4) 0.96 [0.52, 1.76]< 124%18 studies (18/-)55.8 %lowlow highnon important-
Hypothyroidism TRAE (grade 3-4) 0.99 [0.43, 2.25]< 10%19 studies (19/-)51.2 %lowlow highnon important-
Increase AST TRAE (grade 3-4) 2.22 [0.86, 5.74]< 168%16 studies (16/-)5.0 %lowlow highnon important-
Increased ALT TRAE (grade 3-4) 2.78 [1.13, 6.89]< 176%16 studies (16/-)1.3 %lowlow highnon important-
Increased lipase level TRAE (grade 3-4) 1.82 [1.19, 2.78]< 142%9 studies (9/-)0.3 %lownot evaluable highnon important-
Infusion-related reactions TRAE (grade 3-4) 1.45 [0.27, 7.62]< 10%5 studies (5/-)33.2 %lowserious highnon important-
Leucopenia TRAE (grade 3-4) 0.19 [0.05, 0.74]< 10%6 studies (6/-)99.2 %lowserious highnon important-
Maculopapular rash TRAE (grade 3-4) 1.48 [0.95, 2.30]< 10%15 studies (15/-)4.3 %lowlow highnon important-
Metabolism and nutrition disorders TRAE (grade 3-4) 1.44 [0.23, 8.93]< 10%3 studies (3/-)35.0 %lownot evaluable highnon important-
Musculoskeletal and connective tissue disorders TRAE (grade 3-4) 0.95 [0.11, 8.51]< 125%3 studies (3/-)51.7 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 1.15 [0.48, 2.76]< 10%13 studies (13/-)37.4 %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 [0.19, 4.71]< 10%6 studies (6/-)52.7 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 0.84 [0.40, 1.76]< 10%15 studies (15/-)67.6 %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) 3.11 [0.83, 11.67]< 14%5 studies (5/-)4.7 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.23 [0.07, 0.79]< 10%8 studies (8/-)99.1 %some concernserious moderatenon important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.95 [0.10, 9.23]< 10%3 studies (3/-)51.7 %lownot evaluable highnon important-
Pancreatitis TRAE (grade 3-4) 1.56 [0.46, 5.29]< 10%8 studies (8/-)23.7 %lownot evaluable highnon important-
Pancytopenia TRAE (grade 3-4) 0.50 [0.04, 5.71]< 114%2 studies (2/-)71.0 %lownot evaluable highnon important-
Paraesthesia TRAE (grade 3-4) 0.77 [0.20, 2.91]< 10%8 studies (8/-)65.2 %some concernserious moderatenon important-
Pericarditis TRAE (grade 3-4) 1.99 [0.07, 59.56]< 10%1 study (1/-)34.8 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 0.92 [0.24, 3.56]< 10%6 studies (6/-)54.7 %lownot evaluable highnon 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) 2.13 [0.97, 4.66]< 10%14 studies (14/-)2.9 %lowlow highnon important-
Polymyalgia Rheumatica TRAE (grade 3-4) 0.50 [0.02, 14.85]< 10%1 study (1/-)65.5 %NAnot evaluable non important-
Pruritic rash TRAE (grade 3-4) 0.78 [0.18, 3.32]< 10%7 studies (7/-)63.1 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 1.53 [0.78, 3.02]< 10%20 studies (20/-)11.0 %lowcritical highnon important-
Pyrexia TRAE (grade 3-4) 1.38 [0.60, 3.16]< 10%12 studies (12/-)22.5 %lowlow highnon important-
Rash TRAE (grade 3-4) 1.33 [0.82, 2.17]< 113%18 studies (18/-)12.4 %lowlow highnon important-
Renal and urinary disorders TRAE (grade 3-4) 0.99 [0.08, 12.98]< 10%2 studies (2/-)50.3 %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.