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mML - 1st line (L1), 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) 0.61 [0.41, 0.92]< 185%4 studies (4/-)99.1 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.46 [0.36, 0.59]< 10%1 study (1/-)100.0 %NAnot evaluable important-
PFS (extension) 0.42 [0.33, 0.53]< 10%1 study (1/-)100.0 %NAnot evaluable important-
progression or deaths (PFS) 0.53 [0.35, 0.79]< 189%3 studies (3/-)99.9 %lownot evaluable highimportant-
DOR (extension) 3.45 [1.46, 8.18]> 10%1 study (1/-)99.8 %NAnot evaluable non important-
objective responses (ORR) 2.16 [1.06, 4.39]> 190%4 studies (4/-)98.3 %lownot evaluable highnon important-
objective responses (ORR) (extension) 4.50 [2.79, 7.25]> 10%1 study (1/-)100.0 %NAnot evaluable non important-

safety endpoints 00

AE (any grade) 1.35 [0.48, 3.76]< 173%2 studies (2/-)28.5 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 1.26 [0.58, 2.72]< 189%2 studies (2/-)28.2 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.53 [0.86, 2.73]< 10%3 studies (3/-)7.5 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 1.37 [0.38, 5.00]< 184%3 studies (3/-)31.7 %lownot evaluable highnon important-
AE leading to treatment discontinuation (grade 3-4) 0.61 [0.29, 1.28]< 10%1 study (1/-)90.5 %NAnot evaluable non important-
SAE (any grade) 1.53 [0.36, 6.48]< 196%2 studies (2/-)28.1 %some concernnot evaluable moderatenon important-
SAE (grade 3-4) 0.74 [0.47, 1.17]< 10%1 study (1/-)90.4 %NAnot evaluable non important-
STRAE (any grade) 1.20 [0.86, 1.66]< 10%2 studies (2/-)14.4 %lownot evaluable highnon important-
STRAE (grade 3-4) 0.99 [0.44, 2.27]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
TRAE (any grade) 0.93 [0.60, 1.43]< 10%2 studies (2/-)63.7 %lownot evaluable highnon important-
TRAE (grade 3-4) 0.95 [0.43, 2.13]< 181%2 studies (2/-)54.6 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 7.00 [0.86, 57.23]< 10%1 study (1/-)3.6 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 5.93 [0.30, 118.96]< 10%1 study (1/-)12.5 %NAnot evaluable non important-
Alopecia TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Arthralgia TRAE (grade 3-4) 1.40 [0.48, 4.06]< 10%2 studies (2/-)26.8 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 1.79 [0.39, 8.22]< 10%2 studies (2/-)22.8 %lownot evaluable highnon important-
Blood creatinine increased TRAE (grade 3-4) 0.61 [0.02, 18.27]< 10%1 study (1/-)61.1 %NAnot evaluable non important-
Chorioretinopathy TRAE (grade 3-4) 0.61 [0.02, 18.27]< 10%1 study (1/-)61.1 %NAnot evaluable non 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) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Decreased appetite TRAE (grade 3-4) 0.48 [0.04, 5.47]< 10%2 studies (2/-)72.1 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 0.69 [0.24, 2.02]< 10%2 studies (2/-)74.9 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 2.66 [0.23, 30.36]< 10%2 studies (2/-)21.7 %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) 0.98 [0.02, 49.62]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 1.19 [0.09, 16.28]< 147%2 studies (2/-)45.0 %lownot evaluable highnon important-
Headache TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 3.94 [0.18, 87.81]< 10%1 study (1/-)19.6 %NAnot evaluable non important-
Hypersensitivity TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 3.26 [0.33, 32.32]< 10%2 studies (2/-)15.8 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Increase AST TRAE (grade 3-4) 1.00 [0.06, 16.02]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 2.00 [0.18, 22.23]< 10%1 study (1/-)28.8 %NAnot evaluable non important-
Increased lipase level TRAE (grade 3-4) 0.99 [0.64, 1.52]< 10%1 study (1/-)52.3 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 0.12 [0.01, 2.33]< 10%1 study (1/-)91.7 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 1.37 [0.79, 2.37]< 10%2 studies (2/-)13.0 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 1.92 [0.25, 14.93]< 10%2 studies (2/-)26.8 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 0.25 [0.04, 1.62]< 10%2 studies (2/-)92.6 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.05 [0.00, 0.92]< 10%1 study (1/-)97.7 %NAnot evaluable non important-
Pancreatitis TRAE (grade 3-4) 5.93 [0.30, 118.96]< 10%1 study (1/-)12.5 %NAnot evaluable non 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) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non 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) 4.92 [0.22, 109.67]< 10%1 study (1/-)16.0 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 2.29 [0.32, 16.34]< 10%2 studies (2/-)20.5 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 1.04 [0.24, 4.45]< 10%2 studies (2/-)48.0 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 1.00 [0.54, 1.83]< 10%2 studies (2/-)50.3 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 0.05 [0.00, 0.82]< 10%1 study (1/-)98.1 %NAnot evaluable non important-
Vitiligo TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.58 [0.14, 2.41]< 10%2 studies (2/-)77.1 %lownot evaluable highnon important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 4.04 [1.13, 14.45]< 10%1 study (1/-)1.6 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.10 [0.01, 1.78]< 10%1 study (1/-)94.0 %NAnot evaluable non important-
Constipation AE (grade 3-4) 0.98 [0.14, 7.01]< 10%1 study (1/-)50.7 %NAnot evaluable non important-
Cough AE (grade 3-4) 1.97 [0.07, 58.81]< 10%1 study (1/-)35.0 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 14.32 [1.87, 109.52]< 10%1 study (1/-)0.5 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 4.00 [0.84, 18.98]< 10%1 study (1/-)4.1 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 3.90 [1.44, 10.57]< 10%1 study (1/-)0.4 %NAnot evaluable non important-
Headache AE (grade 3-4) 1.97 [0.18, 21.82]< 10%1 study (1/-)29.2 %NAnot evaluable non important-
Hypothyroidism AE (grade 3-4) 1.22 [0.02, 61.84]< 10%1 study (1/-)46.1 %NAnot evaluable non important-
Nausea AE (grade 3-4) 1.39 [0.61, 3.18]< 10%1 study (1/-)21.7 %NAnot evaluable non important-
Neutropenia AE (grade 3-4) 0.03 [0.00, 0.19]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Peripheral oedema AE (grade 3-4) 4.97 [0.58, 42.77]< 10%1 study (1/-)7.3 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 5.93 [0.30, 118.96]< 10%1 study (1/-)12.5 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 7.94 [0.42, 150.76]< 10%1 study (1/-)8.6 %NAnot evaluable non important-
Rash AE (grade 3-4) 7.00 [0.86, 57.23]< 10%1 study (1/-)3.6 %NAnot evaluable non important-
Thrombocytopenia AE (grade 3-4) 0.03 [0.00, 0.26]< 10%1 study (1/-)99.9 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 1.55 [0.66, 3.64]< 10%1 study (1/-)15.7 %NAnot evaluable non important-
Weight decreased AE (grade 3-4) 0.98 [0.06, 15.76]< 10%1 study (1/-)50.5 %NAnot evaluable non 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.