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Extensive stage SCLC (Es-SCLC) - 1st Line (L1), immune chekpoint inhibitors versus Standard of Care (SoC), 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) 0.76 [0.64, 0.89]< 10%2 studies (2/-)99.9 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.76 [0.60, 0.96]< 10%1 study (1/-)99.0 %NAnot evaluable important-
PFS (extension) 0.77 [0.63, 0.95]< 10%1 study (1/-)99.4 %NAnot evaluable important-
progression or deaths (PFS) 0.76 [0.65, 0.88]< 10%2 studies (2/-)100.0 %lownot evaluable highimportant-
objective responses (ORR) 1.12 [0.64, 1.97]> 175%2 studies (2/-)65.2 %lownot evaluable highnon important-
objective responses (ORR) (extension) 0.84 [0.56, 1.25]> 10%1 study (1/-)19.5 %NAnot evaluable non important-

safety endpoints 00

AE (any grade) 14.63 [0.82, 259.59]< 10%1 study (1/-)3.5 %NAnot evaluable non important-
AE (grade 3-4) 1.14 [0.85, 1.54]< 10%2 studies (2/-)19.2 %lownot evaluable highnon important-
AE leading to death (grade 5) 0.71 [0.20, 2.53]< 169%2 studies (2/-)70.0 %lownot evaluable highnon important-
AE leading to treatment discontinuation (any grade) 3.02 [1.77, 5.15]< 10%2 studies (2/-)0.0 %lownot evaluable highnon important-
SAE (any grade) 1.12 [0.74, 1.70]< 10%1 study (1/-)29.0 %NAnot evaluable non important-
STRAE (any grade) 1.26 [0.78, 2.06]< 10%1 study (1/-)17.4 %NAnot evaluable non important-
TRAE (any grade) 1.72 [0.89, 3.32]< 10%2 studies (2/-)5.3 %lownot evaluable highnon important-
TRAE (grade 3-4) 1.07 [0.81, 1.41]< 10%2 studies (2/-)31.4 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 1.00 [0.39, 2.54]< 10%2 studies (2/-)50.3 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Acute kidney injury TRAE (grade 3-4) 3.99 [0.18, 89.04]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 2.35 [0.21, 26.79]< 10%2 studies (2/-)24.8 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 0.67 [0.05, 8.74]< 10%2 studies (2/-)61.9 %lownot evaluable highnon important-
Anaemia TRAE (grade 3-4) 1.13 [0.76, 1.68]< 10%2 studies (2/-)28.0 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 0.49 [0.12, 2.00]< 10%1 study (1/-)83.8 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 1.11 [0.15, 8.06]< 17%2 studies (2/-)46.0 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 0.64 [0.06, 6.33]< 10%2 studies (2/-)64.8 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 0.68 [0.02, 20.43]< 161%2 studies (2/-)58.8 %lownot evaluable highnon important-
Diabetes TRAE (grade 3-4) 1.48 [0.11, 19.35]< 10%2 studies (2/-)38.3 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 2.19 [0.65, 7.31]< 10%2 studies (2/-)10.2 %lownot evaluable highnon important-
Fatigue TRAE (grade 3-4) 3.50 [0.72, 17.02]< 10%2 studies (2/-)6.1 %lownot evaluable highnon important-
Febrile neutropenia TRAE (grade 3-4) 0.48 [0.18, 1.30]< 10%1 study (1/-)92.5 %NAnot evaluable non important-
Guillain-Barré syndrome TRAE (grade 3-4) 1.98 [0.07, 59.51]< 10%1 study (1/-)34.9 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 6.04 [0.72, 50.41]< 10%2 studies (2/-)4.9 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 1.48 [0.11, 19.35]< 10%2 studies (2/-)38.3 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 0.99 [0.06, 15.96]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 0.99 [0.06, 15.96]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
Infusion-related reactions TRAE (grade 3-4) 4.02 [0.45, 36.30]< 10%1 study (1/-)10.9 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 1.26 [0.76, 2.11]< 10%2 studies (2/-)18.5 %lownot evaluable highnon important-
Myocarditis TRAE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Myositis TRAE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 1.00 [0.20, 4.97]< 10%2 studies (2/-)50.2 %lownot evaluable highnon important-
Nephritis TRAE (grade 3-4) 1.99 [0.18, 22.08]< 10%2 studies (2/-)28.8 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.98 [0.73, 1.32]< 10%2 studies (2/-)54.4 %lownot evaluable highnon important-
Pancreatitis TRAE (grade 3-4) 0.79 [0.11, 5.62]< 10%2 studies (2/-)59.4 %lownot evaluable highnon important-
Pancytopenia TRAE (grade 3-4) 0.33 [0.03, 3.17]< 10%1 study (1/-)83.1 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 3.99 [0.18, 89.04]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Pneumonia TRAE (grade 3-4) 6.02 [0.30, 120.88]< 10%1 study (1/-)12.3 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 1.46 [0.13, 16.80]< 139%2 studies (2/-)38.0 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 8.06 [0.42, 153.52]< 10%1 study (1/-)8.5 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 3.81 [0.36, 40.15]< 10%2 studies (2/-)13.5 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 1.25 [0.80, 1.94]< 10%2 studies (2/-)16.2 %lownot evaluable highnon important-
Uveitis TRAE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.66 [0.18, 2.36]< 10%2 studies (2/-)73.8 %lownot evaluable highnon important-

AE (grade 3-4) endpoints 00

Alopecia AE (grade 3-4) 0.50 [0.02, 14.95]< 10%1 study (1/-)65.4 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 1.03 [0.62, 1.73]< 10%1 study (1/-)44.8 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.72 [0.28, 1.82]< 10%1 study (1/-)75.8 %NAnot evaluable non important-
Back pain AE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Constipation AE (grade 3-4) 0.50 [0.04, 5.53]< 10%1 study (1/-)71.4 %NAnot evaluable non important-
Cough AE (grade 3-4) 0.50 [0.04, 5.53]< 10%1 study (1/-)71.4 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 0.25 [0.03, 2.22]< 10%1 study (1/-)89.2 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 1.00 [0.32, 3.15]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Dizziness AE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 0.75 [0.17, 3.37]< 10%1 study (1/-)64.7 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 1.51 [0.42, 5.44]< 10%1 study (1/-)26.3 %NAnot evaluable non important-
Headache AE (grade 3-4) 0.50 [0.02, 14.95]< 10%1 study (1/-)65.4 %NAnot evaluable non important-
Hypothyroidism AE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Leucopenia AE (grade 3-4) 1.27 [0.69, 2.33]< 10%1 study (1/-)22.1 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.66 [0.11, 4.01]< 10%1 study (1/-)67.2 %NAnot evaluable non important-
Neutropenia AE (grade 3-4) 1.12 [0.77, 1.63]< 10%1 study (1/-)28.3 %NAnot evaluable non important-
Peripheral oedema AE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Pneumonia AE (grade 3-4) 1.54 [0.67, 3.50]< 10%1 study (1/-)15.3 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 1.00 [0.06, 16.09]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Rash AE (grade 3-4) 6.07 [0.30, 121.85]< 10%1 study (1/-)12.2 %NAnot evaluable non important-
Thrombocytopenia AE (grade 3-4) 1.28 [0.73, 2.25]< 10%1 study (1/-)19.6 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 0.50 [0.09, 2.73]< 10%1 study (1/-)78.9 %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.