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mML - L2 - all population, immune chekpoint inhibitors versus anti-CTLA-4, 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) 0.80 [0.65, 0.98]< 167%4 studies (4/-)98.5 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.68 [0.57, 0.81]< 10%2 studies (2/-)100.0 %some concernnot evaluable moderateimportant-
PFS (extension) 0.61 [0.53, 0.70]< 10%2 studies (2/-)100.0 %some concernnot evaluable moderateimportant-
progression or deaths (PFS) 0.65 [0.51, 0.84]< 167%3 studies (3/-)100.0 %some concernnot evaluable moderateimportant-
DCR 1.19 [0.86, 1.63]> 10%1 study (1/-)85.6 %NAnot evaluable non important-
objective responses (ORR) 1.78 [0.78, 4.03]> 191%4 studies (4/-)91.5 %some concernnot evaluable moderatenon important-

safety endpoints 00

AE (any grade) 1.96 [0.55, 7.07]< 10%1 study (1/-)15.2 %NAnot evaluable non important-
AE (grade 3-4) 0.99 [0.66, 1.47]< 10%1 study (1/-)52.2 %NAnot evaluable non important-
STRAE (any grade) 0.65 [0.46, 0.92]< 10%2 studies (2/-)99.3 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
TRAE (any grade) 1.74 [1.24, 2.44]< 164%4 studies (4/-)0.1 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 1.22 [0.66, 2.26]< 187%4 studies (4/-)26.0 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.78 [0.43, 7.37]< 10%3 studies (3/-)21.3 %lownot evaluable highnon important-
TRAE leading to discontinuation (any grade) 1.28 [0.72, 2.27]< 174%3 studies (3/-)20.2 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (grade 3-4) 2.23 [1.51, 3.30]< 10%3 studies (3/-)0.0 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Adrenal insufficiency TRAE (grade 3-4) 1.63 [0.16, 16.15]< 10%2 studies (2/-)33.9 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 1.16 [0.16, 8.29]< 10%2 studies (2/-)44.1 %some concernnot evaluable moderatenon important-
Arthralgia TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Asthenia TRAE (grade 3-4) 0.35 [0.05, 2.37]< 10%2 studies (2/-)85.7 %some concernnot evaluable moderatenon important-
Chills TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Colitis TRAE (grade 3-4) 0.55 [0.19, 1.58]< 180%4 studies (4/-)86.5 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Cough TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Diabetes TRAE (grade 3-4) 1.85 [0.06, 55.43]< 10%1 study (1/-)36.3 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 1.01 [0.53, 1.93]< 148%4 studies (4/-)48.9 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Dyspnoea TRAE (grade 3-4) 0.70 [0.08, 6.00]< 10%2 studies (2/-)62.7 %some concernnot evaluable moderatenon important-
Endocrine disorders TRAE (grade 3-4) 0.84 [0.10, 6.86]< 186%2 studies (2/-)56.5 %lownot evaluable highnon important-
Eye disorders TRAE (grade 3-4) 0.50 [0.02, 14.85]< 10%1 study (1/-)65.5 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 0.64 [0.17, 2.37]< 10%2 studies (2/-)74.9 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 3.99 [0.18, 88.89]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Gastrointestinal disorders TRAE (grade 3-4) 1.23 [0.51, 2.94]< 173%2 studies (2/-)32.1 %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) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Hepatitis TRAE (grade 3-4) 2.64 [0.90, 7.72]< 10%4 studies (4/-)3.9 %lownot evaluable highnon important-
Hepatobiliary disorders TRAE (grade 3-4) 2.78 [0.15, 52.88]< 10%1 study (1/-)25.1 %NAnot evaluable non important-
Hypersensitivity TRAE (grade 3-4) 6.01 [0.30, 120.38]< 10%1 study (1/-)12.3 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 0.46 [0.04, 5.09]< 10%2 studies (2/-)73.5 %some concernnot evaluable moderatenon important-
Hypophysitis TRAE (grade 3-4) 0.89 [0.40, 1.97]< 10%4 studies (4/-)61.5 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 1.26 [0.22, 7.29]< 10%4 studies (4/-)39.8 %lownot evaluable highnon important-
Increase AST TRAE (grade 3-4) 1.10 [0.19, 6.17]< 140%4 studies (4/-)45.8 %lownot evaluable highnon important-
Increased ALT TRAE (grade 3-4) 1.32 [0.26, 6.75]< 145%4 studies (4/-)37.0 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 1.99 [0.07, 59.56]< 10%1 study (1/-)34.8 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 3.99 [0.18, 88.89]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 0.94 [0.15, 5.80]< 10%3 studies (3/-)52.5 %some concernnot evaluable moderatenon important-
Myalgia TRAE (grade 3-4) 0.70 [0.08, 6.00]< 10%2 studies (2/-)62.8 %some concernnot evaluable moderatenon important-
Myositis TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Nausea TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Nephritis TRAE (grade 3-4) 0.46 [0.04, 5.09]< 10%2 studies (2/-)73.5 %some concernnot evaluable moderatenon important-
Nervous system disorders TRAE (grade 3-4) 8.03 [0.42, 152.51]< 10%1 study (1/-)8.5 %NAnot evaluable non important-
Neutropenia TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Pancreatitis TRAE (grade 3-4) 1.99 [0.07, 59.56]< 10%1 study (1/-)34.8 %NAnot evaluable non important-
Pancytopenia TRAE (grade 3-4) 1.99 [0.07, 59.56]< 10%1 study (1/-)34.8 %NAnot evaluable non important-
Paraesthesia TRAE (grade 3-4) 0.46 [0.04, 5.09]< 10%2 studies (2/-)73.5 %some concernnot evaluable 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) 3.99 [0.18, 88.89]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 1.63 [0.29, 9.28]< 10%3 studies (3/-)29.0 %some concernnot evaluable moderatenon 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) 0.72 [0.08, 6.18]< 10%3 studies (3/-)61.7 %some concernnot evaluable moderatenon important-
Pruritus TRAE (grade 3-4) 0.91 [0.21, 3.89]< 10%4 studies (4/-)55.0 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Rash TRAE (grade 3-4) 1.87 [0.57, 6.11]< 10%4 studies (4/-)15.0 %lownot evaluable highnon important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 8.03 [0.42, 152.51]< 10%1 study (1/-)8.5 %NAnot evaluable non important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 1.46 [0.58, 3.68]< 10%2 studies (2/-)21.3 %lownot evaluable highnon important-
Thyroiditis TRAE (grade 3-4) 1.99 [0.07, 59.56]< 10%1 study (1/-)34.8 %NAnot evaluable non important-
Uveitis TRAE (grade 3-4) 0.72 [0.08, 6.18]< 10%3 studies (3/-)61.7 %some concernnot evaluable moderatenon important-
Vitiligo TRAE (grade 3-4) 0.34 [0.01, 17.42]< 10%1 study (1/-)69.9 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 1.37 [0.11, 17.90]< 10%2 studies (2/-)40.6 %some concernnot evaluable moderatenon important-
Weight decreased TRAE (grade 3-4) 0.46 [0.04, 5.09]< 10%2 studies (2/-)73.5 %some concernnot evaluable moderatenon important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 1.03 [0.21, 5.19]< 10%1 study (1/-)48.3 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 0.95 [0.30, 3.03]< 10%1 study (1/-)53.7 %NAnot evaluable non important-
Constipation AE (grade 3-4) 0.34 [0.07, 1.70]< 10%1 study (1/-)90.5 %NAnot evaluable non important-
Cough AE (grade 3-4) 0.69 [0.02, 20.65]< 10%1 study (1/-)58.4 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 1.03 [0.21, 5.19]< 10%1 study (1/-)48.3 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 0.83 [0.34, 2.05]< 10%1 study (1/-)65.7 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 0.96 [0.34, 2.73]< 10%1 study (1/-)52.8 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 0.71 [0.31, 1.62]< 10%1 study (1/-)79.0 %NAnot evaluable non important-
Headache AE (grade 3-4) 0.45 [0.10, 2.06]< 10%1 study (1/-)84.7 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.68 [0.17, 2.78]< 10%1 study (1/-)70.2 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 1.38 [0.06, 30.82]< 10%1 study (1/-)42.0 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 0.80 [0.20, 3.14]< 10%1 study (1/-)62.5 %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.