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gastric or gastroesophageal junction cancer (GC), immune chekpoint inhibitors versus chemotherapy, 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) 0.91 [0.83, 1.00]< 123%7 studies (7/-)98.0 %some concernserious moderatecrucial-
progression or deaths (PFS) 1.23 [0.94, 1.63]< 193%7 studies (7/-)6.8 %some concernserious moderateimportant-
DCR 0.49 [0.30, 0.81]> 164%2 studies (2/-)0.3 %some concernnot evaluable moderatenon important-
irORR 0.24 [0.03, 2.19]> 10%1 study (1/-)10.3 %NAnot evaluable non important-
irPFS 1.44 [1.09, 1.91]< 10%1 study (1/-)0.5 %NAnot evaluable non important-
objective responses (ORR) 0.86 [0.48, 1.53]> 191%6 studies (6/-)30.4 %some concernnot evaluable moderatenon important-

safety endpoints 00

AE (any grade) 0.74 [0.33, 1.67]< 151%3 studies (3/-)76.5 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 0.47 [0.10, 2.17]< 198%3 studies (3/-)83.4 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.24 [0.67, 2.31]< 10%3 studies (3/-)24.5 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 0.53 [0.16, 1.78]< 194%3 studies (3/-)84.7 %some concernnot evaluable moderatenon important-
SAE (any grade) 1.26 [0.86, 1.83]< 10%1 study (1/-)11.9 %NAnot evaluable non important-
STRAE (any grade) 1.31 [0.54, 3.21]< 185%2 studies (2/-)27.5 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 1.80 [1.33, 2.44]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
TRAE (any grade) 0.57 [0.24, 1.33]< 196%7 studies (7/-)90.3 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 0.62 [0.21, 1.80]< 197%5 studies (5/-)81.1 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.92 [0.75, 4.94]< 10%5 studies (5/-)8.8 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 0.72 [0.25, 2.01]< 191%5 studies (5/-)73.6 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (grade 3-4) 2.12 [1.55, 2.90]< 10%1 study (1/-)0.0 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Alopecia TRAE (grade 3-4) 0.50 [0.08, 3.03]< 10%4 studies (4/-)77.5 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 0.46 [0.15, 1.40]< 189%5 studies (5/-)91.4 %some concernnot evaluable moderatenon important-
Asthenia TRAE (grade 3-4) 0.54 [0.25, 1.15]< 124%5 studies (5/-)94.5 %some concernnot evaluable moderatenon important-
Blood creatinine increased TRAE (grade 3-4) 0.73 [0.09, 6.29]< 10%2 studies (2/-)61.1 %some concernnot evaluable moderatenon important-
Colitis TRAE (grade 3-4) 0.87 [0.03, 25.93]< 161%2 studies (2/-)53.1 %some concernnot evaluable moderatenon important-
Constipation TRAE (grade 3-4) 0.97 [0.06, 15.52]< 10%2 studies (2/-)50.9 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 0.57 [0.26, 1.27]< 146%6 studies (6/-)91.4 %some concernnot evaluable moderatenon important-
Diabetes TRAE (grade 3-4) 0.94 [0.02, 47.47]< 10%1 study (1/-)51.2 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 0.73 [0.31, 1.73]< 163%6 studies (6/-)76.4 %some concernnot evaluable moderatenon important-
Dizziness TRAE (grade 3-4) 0.73 [0.09, 6.31]< 10%2 studies (2/-)61.0 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 0.97 [0.06, 15.52]< 10%2 studies (2/-)50.9 %some concernnot evaluable moderatenon important-
Dysgeusia TRAE (grade 3-4) 0.97 [0.06, 15.52]< 10%2 studies (2/-)50.9 %some concernnot evaluable moderatenon important-
Endocrine disorders TRAE (grade 3-4) 4.01 [0.37, 43.00]< 12%2 studies (2/-)12.7 %some concernnot evaluable moderatenon important-
Fatigue TRAE (grade 3-4) 0.81 [0.36, 1.81]< 164%6 studies (6/-)69.7 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 0.08 [0.00, 1.40]< 10%1 study (1/-)95.7 %NAnot evaluable non important-
Gastrointestinal disorders TRAE (grade 3-4) 1.73 [1.04, 2.86]< 10%1 study (1/-)1.7 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 7.60 [0.40, 144.43]< 10%1 study (1/-)9.1 %NAnot evaluable non important-
Hepatobiliary disorders TRAE (grade 3-4) 1.81 [0.97, 3.36]< 10%1 study (1/-)3.0 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 0.94 [0.02, 47.47]< 10%1 study (1/-)51.2 %NAnot evaluable non important-
Hypophysitis TRAE (grade 3-4) 3.77 [0.17, 84.06]< 10%1 study (1/-)20.4 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 1.97 [0.36, 10.94]< 10%4 studies (4/-)22.0 %some concernnot evaluable moderatenon important-
Increase AST TRAE (grade 3-4) 1.95 [0.82, 4.61]< 10%2 studies (2/-)6.5 %some concernnot evaluable moderatenon important-
Increased ALT TRAE (grade 3-4) 0.97 [0.38, 2.48]< 10%2 studies (2/-)52.2 %some concernnot evaluable moderatenon important-
Increased lipase level TRAE (grade 3-4) 1.74 [0.36, 8.39]< 150%2 studies (2/-)24.5 %some concernnot evaluable moderatenon important-
Infusion-related reactions TRAE (grade 3-4) 0.95 [0.09, 10.52]< 10%2 studies (2/-)51.6 %some concernnot evaluable moderatenon important-
Leucopenia TRAE (grade 3-4) 2.43 [0.23, 25.98]< 134%2 studies (2/-)23.2 %lownot evaluable highnon important-
Mucosal inflammation TRAE (grade 3-4) 0.20 [0.01, 4.07]< 177%2 studies (2/-)85.1 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 0.79 [0.02, 40.48]< 10%1 study (1/-)54.6 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 0.62 [0.28, 1.36]< 145%6 studies (6/-)88.2 %some concernnot evaluable moderatenon important-
Neutropenia TRAE (grade 3-4) 0.25 [0.08, 0.74]< 188%5 studies (5/-)99.4 %some concernserious moderatenon important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.87 [0.28, 2.71]< 154%4 studies (4/-)59.8 %some concernnot evaluable moderatenon important-
Pancreatitis TRAE (grade 3-4) 0.47 [0.02, 14.02]< 10%1 study (1/-)66.7 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 1.28 [0.74, 2.22]< 12%5 studies (5/-)19.0 %some concernnot evaluable moderatenon important-
Peripheral sensory neuropathy TRAE (grade 3-4) 1.33 [0.50, 3.53]< 110%2 studies (2/-)28.5 %some concernnot evaluable moderatenon important-
Pneumonitis TRAE (grade 3-4) 3.77 [0.17, 84.06]< 10%1 study (1/-)20.4 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 0.90 [0.09, 8.74]< 10%3 studies (3/-)53.4 %some concernnot evaluable moderatenon important-
Rash TRAE (grade 3-4) 1.20 [0.14, 10.36]< 10%3 studies (3/-)43.3 %some concernnot evaluable moderatenon important-
Renal and urinary disorders TRAE (grade 3-4) 5.92 [0.71, 49.31]< 10%1 study (1/-)5.1 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 13.96 [1.83, 106.45]< 10%1 study (1/-)0.6 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 1.88 [0.06, 56.28]< 10%1 study (1/-)36.0 %NAnot evaluable non important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 4.36 [1.79, 10.66]< 10%1 study (1/-)0.1 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 0.34 [0.02, 6.97]< 177%2 studies (2/-)75.7 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 1.00 [0.38, 2.62]< 146%3 studies (3/-)50.3 %some concernnot evaluable moderatenon important-
Vomiting TRAE (grade 3-4) 0.61 [0.32, 1.17]< 122%5 studies (5/-)93.2 %some concernnot evaluable moderatenon important-
Weight decreased TRAE (grade 3-4) 0.44 [0.06, 3.49]< 136%3 studies (3/-)77.9 %some concernnot evaluable moderatenon 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.