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lung cancer : non small cell (NSCLC), Immune checkpoint association 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) 0.81 [0.67, 0.99]< 158%3 studies (3/-)98.1 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.66 [0.55, 0.80]< 10%1 study (1/-)100.0 %NAnot evaluable important-
PFS (extension) 0.68 [0.57, 0.82]< 10%1 study (1/-)100.0 %NAnot evaluable important-
progression or deaths (PFS) 0.79 [0.64, 0.97]< 142%3 studies (3/-)98.8 %some concernnot evaluable moderateimportant-
objective responses (ORR) 1.48 [0.84, 2.64]> 175%3 studies (3/-)91.1 %some concernnot evaluable moderatenon important-

safety endpoints 00

AE (any grade) 0.53 [0.30, 0.91]< 10%2 studies (2/-)98.9 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 0.88 [0.61, 1.27]< 144%2 studies (2/-)74.6 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.93 [1.14, 3.29]< 10%2 studies (2/-)0.8 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 1.33 [0.95, 1.84]< 10%2 studies (2/-)4.7 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (grade 3-4) 2.14 [1.32, 3.47]< 10%1 study (1/-)0.1 %NAnot evaluable non important-
SAE (any grade) 1.86 [1.31, 2.62]< 10%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-
STRAE (any grade) 1.73 [1.33, 2.25]< 10%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 1.70 [1.26, 2.30]< 110%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-
TRAE (any grade) 0.57 [0.21, 1.55]< 193%3 studies (3/-)86.4 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 0.74 [0.36, 1.53]< 191%3 studies (3/-)79.1 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.34 [0.58, 3.12]< 10%3 studies (3/-)24.8 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 2.06 [1.22, 3.47]< 161%3 studies (3/-)0.3 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (grade 3-4) 3.26 [2.13, 4.99]< 10%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-

TRAE (grade 3-4) endpoints 00

Acute kidney injury TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 4.26 [0.71, 25.42]< 10%3 studies (3/-)5.7 %some concernnot evaluable moderatenon important-
Alopecia TRAE (grade 3-4) 0.95 [0.02, 47.95]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 0.14 [0.02, 0.87]< 165%3 studies (3/-)98.2 %some concernnot evaluable moderatenon important-
Asthenia TRAE (grade 3-4) 0.31 [0.10, 0.99]< 11%3 studies (3/-)97.6 %some concernnot evaluable moderatenon important-
Colitis TRAE (grade 3-4) 8.18 [1.51, 44.34]< 10%3 studies (3/-)0.8 %some concernnot evaluable moderatenon important-
Constipation TRAE (grade 3-4) 0.65 [0.05, 8.42]< 10%2 studies (2/-)63.0 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 0.88 [0.37, 2.14]< 10%3 studies (3/-)60.8 %some concernnot evaluable moderatenon important-
Diabetes TRAE (grade 3-4) 1.90 [0.06, 56.82]< 10%1 study (1/-)35.8 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 5.02 [1.92, 13.10]< 10%3 studies (3/-)0.0 %some concernnot evaluable moderatenon important-
Dyspnoea TRAE (grade 3-4) 2.56 [0.11, 57.33]< 10%1 study (1/-)27.9 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 1.22 [0.42, 3.57]< 147%3 studies (3/-)35.5 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 1.38 [0.60, 3.15]< 10%1 study (1/-)22.3 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 4.15 [0.64, 26.90]< 18%2 studies (2/-)6.8 %some concernnot evaluable moderatenon important-
Hypersensitivity TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Hypertension TRAE (grade 3-4) 1.27 [0.11, 14.23]< 10%1 study (1/-)42.2 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 1.19 [0.09, 15.52]< 10%2 studies (2/-)44.8 %some concernnot evaluable moderatenon important-
Hypophysitis TRAE (grade 3-4) 1.56 [0.14, 17.23]< 10%2 studies (2/-)36.0 %some concernnot evaluable moderatenon important-
Hypothyroidism TRAE (grade 3-4) 2.33 [0.33, 16.43]< 10%3 studies (3/-)19.8 %some concernnot evaluable moderatenon important-
Increase AST TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 1.73 [0.42, 7.13]< 10%2 studies (2/-)22.5 %some concernnot evaluable moderatenon important-
Increased lipase level TRAE (grade 3-4) 4.56 [0.64, 32.21]< 128%2 studies (2/-)6.5 %some concernnot evaluable moderatenon important-
Infusion-related reactions TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 0.10 [0.01, 2.08]< 10%1 study (1/-)92.8 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 4.93 [0.57, 42.41]< 10%1 study (1/-)7.4 %NAnot evaluable non important-
Myositis TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 0.63 [0.12, 3.21]< 138%3 studies (3/-)71.0 %some concernnot evaluable moderatenon important-
Nephritis TRAE (grade 3-4) 0.95 [0.02, 47.95]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Neutropenia TRAE (grade 3-4) 0.08 [0.00, 1.55]< 184%3 studies (3/-)95.1 %some concernnot evaluable moderatenon important-
Pancreatitis TRAE (grade 3-4) 2.56 [0.11, 57.33]< 10%1 study (1/-)27.9 %NAnot evaluable non important-
Peripheral oedema TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Pneumonia TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 7.30 [1.34, 39.79]< 10%2 studies (2/-)1.1 %some concernnot evaluable moderatenon important-
Pruritic rash TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 1.98 [0.26, 15.16]< 10%3 studies (3/-)25.7 %some concernnot evaluable moderatenon important-
Pyrexia TRAE (grade 3-4) 0.32 [0.01, 9.50]< 10%1 study (1/-)74.3 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 1.36 [0.17, 11.00]< 145%3 studies (3/-)38.6 %some concernnot evaluable moderatenon important-
Stomatitis TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 0.22 [0.02, 2.51]< 172%3 studies (3/-)88.8 %some concernnot evaluable moderatenon important-
Thyroiditis TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.44 [0.07, 2.61]< 143%3 studies (3/-)81.7 %some concernnot evaluable moderatenon important-
Weight decreased TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-

AE (grade 3-4) endpoints 00

Alopecia AE (grade 3-4) 0.95 [0.02, 47.95]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 0.12 [0.05, 0.28]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.86 [0.36, 2.05]< 10%1 study (1/-)63.4 %NAnot evaluable non important-
Back pain AE (grade 3-4) 0.63 [0.10, 3.80]< 10%1 study (1/-)69.2 %NAnot evaluable non important-
Constipation AE (grade 3-4) 1.90 [0.17, 21.07]< 10%1 study (1/-)30.1 %NAnot evaluable non important-
Cough AE (grade 3-4) 0.95 [0.02, 47.95]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 1.43 [0.40, 5.11]< 10%1 study (1/-)29.1 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 2.12 [0.73, 6.17]< 10%1 study (1/-)8.4 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 1.11 [0.37, 3.33]< 10%1 study (1/-)42.7 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 1.31 [0.52, 3.31]< 10%1 study (1/-)28.1 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.63 [0.18, 2.25]< 10%1 study (1/-)76.2 %NAnot evaluable non important-
Neutropenia AE (grade 3-4) 0.01 [0.00, 0.19]< 10%1 study (1/-)99.9 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 0.95 [0.02, 47.95]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 0.95 [0.02, 47.95]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Rash AE (grade 3-4) 0.95 [0.06, 15.23]< 10%1 study (1/-)51.5 %NAnot evaluable non important-
Thrombocytopenia AE (grade 3-4) 0.03 [0.00, 0.42]< 10%1 study (1/-)99.4 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 0.13 [0.02, 1.09]< 10%1 study (1/-)96.9 %NAnot evaluable non important-
Weight decreased AE (grade 3-4) 2.86 [0.30, 27.64]< 10%1 study (1/-)18.3 %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.