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metastatic/adv melanoma (mML), anti-CTLA-4 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) 0.80 [0.66, 0.98]< 158%2 studies (2/-)98.6 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.69 [0.57, 0.84]< 10%1 study (1/-)100.0 %NAnot evaluable important-
progression or deaths (PFS) 0.76 [0.63, 0.92]< 10%1 study (1/-)99.7 %NAnot evaluable important-
DCR 1.15 [0.79, 1.68]> 10%1 study (1/-)76.8 %NAnot evaluable non important-
objective responses (ORR) 1.32 [0.91, 1.90]> 10%2 studies (2/-)93.1 %some concernnot evaluable moderatenon important-

safety endpoints 00

AE (any grade) 2.86 [1.34, 6.10]< 126%2 studies (2/-)0.3 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 2.48 [1.36, 4.51]< 183%2 studies (2/-)0.1 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.68 [0.84, 3.36]< 10%2 studies (2/-)7.1 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 97.13 [5.95, 1585.40]< 10%1 study (1/-)0.1 %NAnot evaluable non important-
SAE (any grade) 3.19 [2.19, 4.65]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
TRAE (any grade) 5.64 [3.80, 8.35]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
TRAE (grade 3-4) 11.25 [6.30, 20.10]< 10%1 study (1/-)0.0 %NAnot evaluable non 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

Adrenal insufficiency TRAE (grade 3-4) 5.93 [0.30, 118.96]< 10%1 study (1/-)12.5 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 10.35 [0.56, 190.49]< 10%1 study (1/-)6.0 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 21.14 [1.23, 363.94]< 10%1 study (1/-)1.9 %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-
Hepatitis TRAE (grade 3-4) 5.81 [0.69, 49.23]< 10%2 studies (2/-)5.4 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 1.02 [0.02, 51.42]< 10%1 study (1/-)49.7 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 1.02 [0.02, 51.42]< 10%1 study (1/-)49.7 %NAnot evaluable non important-
Increase AST TRAE (grade 3-4) 52.70 [7.19, 385.99]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 32.40 [7.79, 134.72]< 10%1 study (1/-)0.0 %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-
Pruritus TRAE (grade 3-4) 10.35 [0.56, 190.49]< 10%1 study (1/-)6.0 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 6.16 [0.31, 123.62]< 10%1 study (1/-)12.0 %NAnot evaluable non important-
Thyroiditis TRAE (grade 3-4) 1.02 [0.02, 51.42]< 10%1 study (1/-)49.7 %NAnot evaluable non important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 1.33 [0.15, 12.01]< 182%2 studies (2/-)39.9 %some concernnot evaluable moderatenon important-
Asthenia AE (grade 3-4) 0.14 [0.02, 0.77]< 10%2 studies (2/-)98.8 %lownot evaluable highnon important-
Chills AE (grade 3-4) 1.02 [0.02, 51.42]< 10%1 study (1/-)49.7 %NAnot evaluable non important-
Constipation AE (grade 3-4) 0.99 [0.17, 5.73]< 10%2 studies (2/-)50.5 %some concernnot evaluable moderatenon important-
Cough AE (grade 3-4) 2.00 [0.18, 22.13]< 10%2 studies (2/-)28.7 %some concernnot evaluable moderatenon important-
Decreased appetite AE (grade 3-4) 3.03 [0.17, 53.71]< 181%2 studies (2/-)22.7 %lownot evaluable highnon important-
Diarrhoea AE (grade 3-4) 21.14 [1.23, 363.94]< 10%1 study (1/-)1.9 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 5.55 [1.41, 21.79]< 10%2 studies (2/-)0.7 %some concernnot evaluable moderatenon important-
Fatigue AE (grade 3-4) 2.86 [1.61, 5.08]< 10%2 studies (2/-)0.0 %lownot evaluable highnon important-
Headache AE (grade 3-4) 2.94 [0.58, 14.91]< 10%2 studies (2/-)9.7 %lownot evaluable highnon important-
Increase AST AE (grade 3-4) 18.42 [5.64, 60.14]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
Increased ALT AE (grade 3-4) 34.83 [8.39, 144.67]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
Nausea AE (grade 3-4) 1.38 [0.67, 2.86]< 10%2 studies (2/-)19.0 %some concernnot evaluable moderatenon 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) 7.90 [0.98, 63.82]< 10%2 studies (2/-)2.7 %lownot evaluable highnon important-
Pyrexia AE (grade 3-4) 3.79 [0.36, 39.89]< 10%2 studies (2/-)13.6 %some concernnot evaluable moderatenon important-
Rash AE (grade 3-4) 6.71 [1.20, 37.51]< 10%2 studies (2/-)1.5 %some concernnot evaluable moderatenon 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) 1.70 [0.85, 3.42]< 10%2 studies (2/-)6.7 %some concernnot evaluable moderatenon important-
Weight decreased AE (grade 3-4) 1.00 [0.14, 7.12]< 10%2 studies (2/-)50.1 %some concernnot evaluable moderatenon 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.