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melanoma (ML), nivolumab alone , 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) 0.68 [0.40, 1.15]< 193%5 studies (5/-)92.5 %lowserious highcrucial-
deaths (OS) (extension) 0.71 [0.41, 1.20]< 195%3 studies (3/-)90.0 %lownot evaluable highimportant-
MFS 0.73 [0.56, 0.96]< 10%1 study (1/-)98.8 %NAnot evaluable important-
PFS (extension) 0.66 [0.34, 1.26]< 197%3 studies (3/-)89.7 %lownot evaluable highimportant-
progression or deaths (PFS) 0.62 [0.34, 1.10]< 196%4 studies (4/-)94.8 %lownot evaluable highimportant-
RFS (extension) 0.71 [0.59, 0.85]< 10%1 study (1/-)100.0 %NAnot evaluable important-
RFS/DFS 0.92 [0.45, 1.89]< 186%3 studies (3/-)59.3 %lownot evaluable highimportant-
DOR (extension) 3.45 [1.46, 8.18]> 10%1 study (1/-)99.8 %NAnot evaluable non important-
objective responses (ORR) 2.35 [0.77, 7.20]> 196%4 studies (4/-)93.3 %lownot evaluable highnon important-
objective responses (ORR) (extension) 1.38 [0.16, 11.98]> 199%3 studies (3/-)61.5 %lownot evaluable highnon important-

safety endpoints 00

AE (any grade) 0.63 [0.35, 1.17]< 10%2 studies (2/-)92.8 %lownot evaluable highnon important-
AE (grade 3-4) 0.48 [0.16, 1.41]< 195%2 studies (2/-)90.9 %lownot evaluable highnon important-
AE leading to death (grade 5) 0.97 [0.10, 9.38]< 10%3 studies (3/-)51.1 %lownot evaluable highnon important-
AE leading to treatment discontinuation (any grade) 0.34 [0.11, 1.04]< 189%4 studies (4/-)97.1 %lownot evaluable highnon important-
AE leading to treatment discontinuation (grade 3-4) 0.31 [0.09, 1.14]< 188%4 studies (4/-)96.1 %lownot evaluable highnon important-
SAE (any grade) 0.64 [0.30, 1.34]< 174%3 studies (3/-)88.2 %lownot evaluable highnon important-
SAE (grade 3-4) 0.78 [0.29, 2.12]< 182%3 studies (3/-)68.9 %lownot evaluable highnon important-
STRAE (any grade) 0.94 [0.17, 5.12]< 189%3 studies (3/-)52.9 %lownot evaluable highnon important-
STRAE (grade 3-4) 0.97 [0.17, 5.43]< 184%3 studies (3/-)51.3 %lownot evaluable highnon important-
TRAE (any grade) 0.65 [0.30, 1.39]< 189%6 studies (6/-)86.9 %lownot evaluable highnon important-
TRAE (grade 3-4) 0.44 [0.22, 0.86]< 192%6 studies (6/-)99.1 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 0.66 [0.13, 3.47]< 10%5 studies (5/-)68.7 %lowserious highnon important-
TRAE leading to discontinuation (any grade) 0.30 [0.12, 0.74]< 192%5 studies (5/-)99.5 %lownot evaluable highnon important-
TRAE leading to discontinuation (grade 3-4) 0.23 [0.09, 0.56]< 187%5 studies (5/-)99.9 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.56 [0.13, 2.41]< 10%6 studies (6/-)78.1 %lowserious highnon important-
Acute kidney injury TRAE (grade 3-4) 0.64 [0.05, 8.40]< 10%2 studies (2/-)63.3 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 0.56 [0.21, 1.47]< 10%5 studies (5/-)88.1 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 0.96 [0.10, 9.32]< 10%3 studies (3/-)51.3 %lownot evaluable highnon important-
Anaemia TRAE (grade 3-4) 0.73 [0.08, 6.29]< 10%3 studies (3/-)61.3 %lownot evaluable highnon important-
Arthralgia TRAE (grade 3-4) 1.15 [0.35, 3.79]< 10%6 studies (6/-)41.0 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 0.45 [0.12, 1.66]< 10%4 studies (4/-)88.3 %lownot evaluable highnon important-
Blood and lymphatic system disorders TRAE (grade 3-4) 2.98 [0.27, 32.69]< 10%2 studies (2/-)18.8 %lownot evaluable highnon important-
Blood creatinine increased TRAE (grade 3-4) 0.91 [0.02, 46.72]< 10%1 study (1/-)51.8 %NAnot evaluable non important-
Chills TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Colitis TRAE (grade 3-4) 0.12 [0.06, 0.28]< 10%4 studies (4/-)100.0 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Cough TRAE (grade 3-4) 2.01 [0.42, 9.75]< 10%5 studies (5/-)19.3 %lowserious highnon important-
Decreased appetite TRAE (grade 3-4) 0.46 [0.09, 2.24]< 10%5 studies (5/-)83.2 %lowserious highnon important-
Diabetes TRAE (grade 3-4) 1.94 [0.27, 13.89]< 10%3 studies (3/-)25.6 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 0.36 [0.18, 0.69]< 139%6 studies (6/-)99.9 %lownot evaluable highnon important-
Dizziness TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 0.98 [0.17, 5.66]< 10%5 studies (5/-)51.1 %lownot evaluable highnon important-
Dysgeusia TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Dyspepsia TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Dyspnoea TRAE (grade 3-4) 0.67 [0.14, 3.21]< 10%4 studies (4/-)69.0 %lownot evaluable highnon important-
Endocrine disorders TRAE (grade 3-4) 0.39 [0.05, 3.31]< 120%2 studies (2/-)80.4 %lownot evaluable highnon important-
Eye disorders TRAE (grade 3-4) 0.64 [0.05, 8.40]< 10%2 studies (2/-)63.3 %lownot evaluable highnon important-
Fatigue TRAE (grade 3-4) 0.43 [0.20, 0.96]< 10%6 studies (6/-)98.1 %lownot evaluable highnon important-
Gastritis TRAE (grade 3-4) 0.40 [0.03, 4.62]< 10%2 studies (2/-)76.7 %lownot evaluable highnon important-
Gastrointestinal disorders TRAE (grade 3-4) 0.13 [0.04, 0.40]< 125%3 studies (3/-)100.0 %lownot evaluable highnon important-
General disorders and administration site conditions TRAE (grade 3-4) 0.40 [0.03, 4.62]< 10%2 studies (2/-)76.7 %lownot evaluable highnon important-
Headache TRAE (grade 3-4) 0.34 [0.10, 1.23]< 10%6 studies (6/-)95.0 %lowserious highnon important-
Hepatitis TRAE (grade 3-4) 0.42 [0.11, 1.55]< 15%4 studies (4/-)90.3 %lownot evaluable highnon important-
Hepatobiliary disorders TRAE (grade 3-4) 0.22 [0.06, 0.77]< 150%3 studies (3/-)99.1 %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) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 0.54 [0.14, 2.03]< 10%6 studies (6/-)81.9 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 0.27 [0.10, 0.73]< 10%5 studies (5/-)99.5 %lowserious highnon important-
Hypothyroidism TRAE (grade 3-4) 0.70 [0.17, 2.79]< 10%6 studies (6/-)69.5 %lowserious highnon important-
Increase AST TRAE (grade 3-4) 0.40 [0.14, 1.16]< 154%6 studies (6/-)95.3 %lowserious highnon important-
Increased ALT TRAE (grade 3-4) 0.36 [0.15, 0.89]< 157%6 studies (6/-)98.6 %lowserious highnon important-
Increased lipase level TRAE (grade 3-4) 0.60 [0.30, 1.18]< 145%4 studies (4/-)93.0 %lownot evaluable highnon important-
Infusion-related reactions TRAE (grade 3-4) 0.96 [0.10, 9.32]< 10%3 studies (3/-)51.3 %lownot evaluable highnon important-
Leucopenia TRAE (grade 3-4) 0.36 [0.05, 2.73]< 10%3 studies (3/-)83.7 %lownot evaluable highnon important-
Maculopapular rash TRAE (grade 3-4) 0.48 [0.17, 1.36]< 10%6 studies (6/-)91.6 %lownot evaluable highnon important-
Metabolism and nutrition disorders TRAE (grade 3-4) 1.26 [0.14, 10.99]< 10%2 studies (2/-)41.7 %lownot evaluable highnon important-
Musculoskeletal and connective tissue disorders TRAE (grade 3-4) 5.94 [0.70, 50.19]< 10%2 studies (2/-)5.2 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 1.46 [0.33, 6.44]< 10%5 studies (5/-)31.1 %lownot evaluable highnon important-
Myositis TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 0.44 [0.11, 1.80]< 10%6 studies (6/-)87.3 %lowserious highnon important-
Nervous system disorders TRAE (grade 3-4) 2.53 [0.37, 17.24]< 10%2 studies (2/-)17.2 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.23 [0.03, 1.71]< 10%3 studies (3/-)92.3 %lownot evaluable highnon important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Pancreatitis TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %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) 0.96 [0.10, 9.32]< 10%3 studies (3/-)51.3 %lownot evaluable highnon important-
Peripheral neuropathy TRAE (grade 3-4) 0.64 [0.05, 8.40]< 10%2 studies (2/-)63.3 %lownot evaluable highnon important-
Pneumonitis TRAE (grade 3-4) 0.61 [0.14, 2.70]< 10%4 studies (4/-)74.1 %lownot evaluable highnon important-
Pruritic rash TRAE (grade 3-4) 1.00 [0.06, 15.97]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 0.40 [0.12, 1.35]< 10%6 studies (6/-)92.9 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 0.36 [0.09, 1.38]< 10%6 studies (6/-)93.2 %lowserious highnon important-
Rash TRAE (grade 3-4) 0.29 [0.13, 0.66]< 10%4 studies (4/-)99.8 %lownot evaluable 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) 0.36 [0.05, 2.74]< 10%3 studies (3/-)83.6 %lownot evaluable highnon important-
Sarcoidosis TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 0.22 [0.09, 0.52]< 10%3 studies (3/-)100.0 %lownot evaluable highnon important-
Stomatitis TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 0.20 [0.03, 1.34]< 10%3 studies (3/-)95.1 %lownot evaluable highnon important-
Thyroiditis TRAE (grade 3-4) 0.79 [0.12, 5.19]< 10%4 studies (4/-)59.9 %lownot evaluable highnon important-
Uveitis TRAE (grade 3-4) 0.95 [0.06, 15.31]< 10%2 studies (2/-)51.6 %lownot evaluable highnon important-
Vitiligo TRAE (grade 3-4) 1.36 [0.26, 7.07]< 10%5 studies (5/-)35.9 %lowserious highnon important-
Vomiting TRAE (grade 3-4) 0.48 [0.13, 1.71]< 10%5 studies (5/-)87.1 %lownot evaluable highnon important-
Weight decreased TRAE (grade 3-4) 0.78 [0.12, 5.19]< 10%4 studies (4/-)59.9 %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.