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mML - 1st line (L1), immune chekpoint inhibitors versus 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) 0.67 [0.56, 0.80]< 142%5 studies (5/-)100.0 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.65 [0.50, 0.84]< 179%3 studies (3/-)100.0 %lownot evaluable highimportant-
PFS (extension) 0.52 [0.37, 0.71]< 187%4 studies (4/-)100.0 %lownot evaluable highimportant-
progression or deaths (PFS) 0.61 [0.42, 0.89]< 187%5 studies (5/-)99.5 %lownot evaluable highimportant-
DCR 0.91 [0.63, 1.32]> 10%1 study (1/-)31.6 %NAnot evaluable non important-
objective responses (ORR) 3.28 [1.32, 8.18]> 195%5 studies (5/-)99.5 %lownot evaluable highnon important-
objective responses (ORR) (extension) 5.60 [3.83, 8.17]> 165%4 studies (4/-)100.0 %lownot evaluable highnon important-

safety endpoints 00

AE (any grade) 14.27 [3.34, 61.03]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
AE (grade 3-4) 4.03 [2.70, 6.00]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
AE leading to death (grade 5) 1.39 [0.43, 4.44]< 10%1 study (1/-)29.1 %NAnot evaluable non important-
TRAE (any grade) 1.91 [0.84, 4.34]< 182%4 studies (4/-)6.0 %lownot evaluable highnon important-
TRAE (grade 3-4) 2.63 [1.01, 6.84]< 195%4 studies (4/-)2.4 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 1.00 [0.10, 9.59]< 10%3 studies (3/-)50.1 %lownot evaluable highnon important-
TRAE leading to discontinuation (any grade) 2.73 [1.08, 6.91]< 193%4 studies (4/-)1.7 %lownot evaluable highnon important-
TRAE leading to discontinuation (grade 3-4) 2.30 [0.82, 6.41]< 193%4 studies (4/-)5.6 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.48 [0.11, 2.14]< 10%4 studies (4/-)83.1 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 1.98 [0.57, 6.89]< 130%4 studies (4/-)14.3 %lownot evaluable highnon important-
Arthralgia TRAE (grade 3-4) 1.91 [0.41, 8.82]< 10%4 studies (4/-)20.4 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 0.59 [0.15, 2.28]< 10%4 studies (4/-)77.9 %lownot evaluable highnon important-
Chills TRAE (grade 3-4) 0.49 [0.01, 24.92]< 10%1 study (1/-)63.7 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 1.35 [0.29, 6.37]< 189%4 studies (4/-)35.3 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 0.98 [0.03, 29.71]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Cough TRAE (grade 3-4) 1.00 [0.15, 6.76]< 10%3 studies (3/-)50.2 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 2.44 [0.57, 10.42]< 10%4 studies (4/-)11.5 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 1.32 [0.58, 3.01]< 176%4 studies (4/-)25.6 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 1.34 [0.62, 2.88]< 10%3 studies (3/-)22.7 %lownot evaluable highnon important-
Dyspnoea TRAE (grade 3-4) 3.27 [0.80, 13.40]< 10%4 studies (4/-)5.0 %lownot evaluable highnon important-
Endocrine disorders TRAE (grade 3-4) 1.24 [0.23, 6.63]< 10%1 study (1/-)40.3 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 3.23 [1.52, 6.88]< 10%4 studies (4/-)0.1 %lownot evaluable highnon important-
Gastrointestinal disorders TRAE (grade 3-4) 2.22 [0.77, 6.34]< 10%1 study (1/-)6.9 %NAnot evaluable non important-
Headache TRAE (grade 3-4) 1.80 [0.42, 7.77]< 10%4 studies (4/-)21.7 %lownot evaluable highnon important-
Hepatitis TRAE (grade 3-4) 5.06 [1.06, 24.09]< 10%4 studies (4/-)2.1 %lownot evaluable highnon important-
Hepatobiliary disorders TRAE (grade 3-4) 15.93 [0.93, 273.74]< 10%1 study (1/-)3.0 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 2.72 [0.51, 14.70]< 10%4 studies (4/-)12.3 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 0.84 [0.27, 2.68]< 138%4 studies (4/-)61.2 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 1.27 [0.21, 7.83]< 10%4 studies (4/-)39.8 %lownot evaluable highnon important-
Increase AST TRAE (grade 3-4) 5.63 [2.53, 12.55]< 10%4 studies (4/-)0.0 %lownot evaluable highnon important-
Increased ALT TRAE (grade 3-4) 3.93 [1.32, 11.74]< 162%4 studies (4/-)0.7 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 2.26 [1.41, 3.63]< 124%4 studies (4/-)0.0 %lownot evaluable highnon important-
Maculopapular rash TRAE (grade 3-4) 3.32 [1.15, 9.57]< 10%4 studies (4/-)1.3 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 1.22 [0.23, 6.34]< 10%4 studies (4/-)40.7 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 1.87 [0.38, 9.32]< 140%4 studies (4/-)22.3 %lownot evaluable highnon important-
Pneumonitis TRAE (grade 3-4) 1.85 [0.55, 6.18]< 10%4 studies (4/-)15.9 %lownot evaluable highnon important-
Pruritic rash TRAE (grade 3-4) 0.83 [0.12, 5.93]< 10%4 studies (4/-)57.2 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 3.36 [0.98, 11.50]< 10%4 studies (4/-)2.7 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 1.98 [0.46, 8.48]< 10%4 studies (4/-)17.9 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 2.03 [0.45, 9.22]< 159%4 studies (4/-)18.0 %lownot evaluable highnon important-
Renal and urinary disorders TRAE (grade 3-4) 0.98 [0.03, 29.71]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 1.48 [0.15, 14.67]< 10%1 study (1/-)36.9 %NAnot evaluable non important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 9.64 [0.55, 170.02]< 10%1 study (1/-)6.3 %NAnot evaluable non important-
Thyroiditis TRAE (grade 3-4) 1.65 [0.21, 12.81]< 10%3 studies (3/-)31.7 %lownot evaluable highnon important-
Vitiligo TRAE (grade 3-4) 0.85 [0.14, 5.26]< 10%4 studies (4/-)56.7 %lownot evaluable highnon important-
Vomiting TRAE (grade 3-4) 3.76 [1.11, 12.79]< 10%4 studies (4/-)1.7 %lownot evaluable highnon important-
Weight decreased TRAE (grade 3-4) 0.60 [0.08, 4.66]< 10%3 studies (3/-)68.6 %lownot evaluable highnon important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 0.98 [0.14, 7.03]< 10%1 study (1/-)50.7 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 1.74 [0.50, 6.04]< 10%1 study (1/-)19.1 %NAnot evaluable non important-
Arthralgia AE (grade 3-4) 0.98 [0.02, 49.71]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 1.74 [0.50, 6.04]< 10%1 study (1/-)19.1 %NAnot evaluable non important-
Constipation AE (grade 3-4) 0.98 [0.02, 49.71]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 1.97 [0.07, 58.97]< 10%1 study (1/-)35.0 %NAnot evaluable non important-
Dermatitis acneiform AE (grade 3-4) 22.68 [1.32, 388.47]< 10%1 study (1/-)1.7 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 4.44 [1.47, 13.42]< 10%1 study (1/-)0.4 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 1.65 [0.39, 7.00]< 10%1 study (1/-)24.9 %NAnot evaluable non important-
Headache AE (grade 3-4) 1.97 [0.07, 58.97]< 10%1 study (1/-)35.0 %NAnot evaluable non important-
Hypertension AE (grade 3-4) 1.77 [0.73, 4.30]< 10%1 study (1/-)10.5 %NAnot evaluable non important-
Increase AST AE (grade 3-4) 3.00 [0.60, 15.03]< 10%1 study (1/-)9.1 %NAnot evaluable non important-
Increased ALT AE (grade 3-4) 1.99 [0.49, 8.06]< 10%1 study (1/-)16.8 %NAnot evaluable non important-
Increased Lipase Level AE (grade 3-4) 2.00 [0.59, 6.74]< 10%1 study (1/-)13.2 %NAnot evaluable non important-
Nausea AE (grade 3-4) 10.02 [0.54, 184.60]< 10%1 study (1/-)6.3 %NAnot evaluable non important-
Peripheral oedema AE (grade 3-4) 0.98 [0.06, 15.80]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 0.98 [0.02, 49.71]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 6.03 [0.72, 50.50]< 10%1 study (1/-)5.0 %NAnot evaluable non important-
Rash AE (grade 3-4) 7.83 [1.77, 34.66]< 10%1 study (1/-)0.3 %NAnot evaluable non important-
Rash maculopapular AE (grade 3-4) 7.98 [0.42, 151.89]< 10%1 study (1/-)8.6 %NAnot evaluable non important-
Sepsis AE (grade 3-4) 12.08 [0.67, 217.70]< 10%1 study (1/-)4.7 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 2.49 [0.48, 12.97]< 10%1 study (1/-)14.0 %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.