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urothelial cancer (UC) - bladder cancer (BC), immune chekpoint inhibitors versus non active control, 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 [0.62, 0.93]< 135%2 studies (2/-)99.6 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.76 [0.63, 0.92]< 10%1 study (1/-)99.8 %NAnot evaluable important-
PFS (extension) 0.54 [0.45, 0.64]< 10%1 study (1/-)100.0 %NAnot evaluable important-
progression or deaths (PFS) 0.62 [0.52, 0.74]< 10%1 study (1/-)100.0 %NAnot evaluable important-
RFS/DFS 0.72 [0.59, 0.88]< 10%1 study (1/-)99.9 %NAnot evaluable important-
DCR 1.85 [1.35, 2.54]> 10%1 study (1/-)100.0 %NAnot evaluable non important-
DMFS 0.75 [0.59, 0.95]< 10%1 study (1/-)99.2 %NAnot evaluable non important-
events or deaths (EFS) 0.80 [0.63, 1.01]< 157%2 studies (2/-)96.9 %some concernnot evaluable moderatenon important-
objective responses (ORR) 7.46 [2.53, 21.97]> 10%1 study (1/-)100.0 %NAnot evaluable non important-

safety endpoints 00

AE (any grade) 13.83 [6.28, 30.48]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
AE (grade 3-4) 3.85 [2.72, 5.44]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
AE leading to death (grade 5) 4.03 [0.18, 89.68]< 10%1 study (1/-)19.2 %NAnot evaluable non important-
AE leading to treatment discontinuation (any grade) 93.23 [5.71, 1522.42]< 10%1 study (1/-)0.1 %NAnot evaluable non important-
SAE (any grade) 1.55 [1.09, 2.21]< 10%1 study (1/-)0.8 %NAnot evaluable non important-
STRAE (any grade) 68.24 [4.16, 1120.28]< 10%1 study (1/-)0.2 %NAnot evaluable non important-
TRAE (any grade) 27.97 [0.30, 2613.16]< 199%2 studies (2/-)8.0 %lownot evaluable highnon important-
TRAE (grade 3-4) 10.57 [0.11, 986.65]< 191%2 studies (2/-)16.0 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
TRAE leading to discontinuation (any grade) 73.11 [4.46, 1198.64]< 10%1 study (1/-)0.1 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Acute kidney injury TRAE (grade 3-4) 3.98 [0.18, 88.64]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 1.00 [0.06, 15.97]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
Arthralgia TRAE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Arthritis TRAE (grade 3-4) 1.00 [0.02, 50.69]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 2.34 [0.21, 26.70]< 10%2 studies (2/-)24.8 %lownot evaluable highnon important-
Blood creatinine increased TRAE (grade 3-4) 1.99 [0.07, 59.38]< 10%1 study (1/-)34.8 %NAnot evaluable non important-
Chills TRAE (grade 3-4) 1.00 [0.02, 50.69]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 1.91 [0.40, 9.05]< 10%2 studies (2/-)20.7 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 3.98 [0.18, 88.64]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Dermatitis acneiform TRAE (grade 3-4) 0.99 [0.02, 50.11]< 10%1 study (1/-)50.2 %NAnot evaluable non important-
Diabetes TRAE (grade 3-4) 1.00 [0.06, 15.97]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 2.27 [0.32, 16.21]< 10%2 studies (2/-)20.7 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 1.00 [0.02, 50.69]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Eczema TRAE (grade 3-4) 0.99 [0.02, 50.11]< 10%1 study (1/-)50.2 %NAnot evaluable non important-
Endocrine disorders TRAE (grade 3-4) 1.99 [0.07, 59.38]< 10%1 study (1/-)34.8 %NAnot evaluable non important-
Erythema TRAE (grade 3-4) 0.99 [0.02, 50.11]< 10%1 study (1/-)50.2 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 2.00 [0.18, 22.08]< 10%2 studies (2/-)28.8 %lownot evaluable highnon important-
Gastrointestinal disorders TRAE (grade 3-4) 2.00 [0.50, 8.06]< 10%1 study (1/-)16.5 %NAnot evaluable non important-
Guillain-Barré syndrome TRAE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 1.00 [0.02, 50.69]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Increase AST TRAE (grade 3-4) 1.99 [0.07, 59.38]< 10%1 study (1/-)34.8 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 3.98 [0.18, 88.64]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Increased lipase level TRAE (grade 3-4) 20.63 [1.20, 354.60]< 10%1 study (1/-)2.0 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 6.06 [0.30, 121.47]< 10%1 study (1/-)12.2 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 3.98 [0.18, 88.64]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Myositis TRAE (grade 3-4) 4.03 [0.18, 89.68]< 10%1 study (1/-)19.2 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 1.48 [0.11, 19.36]< 10%2 studies (2/-)38.3 %some concernnot evaluable moderatenon important-
Nephritis TRAE (grade 3-4) 1.48 [0.11, 19.33]< 10%2 studies (2/-)38.3 %lownot evaluable highnon important-
Pancreatitis TRAE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 2.00 [0.18, 22.08]< 10%2 studies (2/-)28.8 %lownot evaluable highnon important-
Pruritic rash TRAE (grade 3-4) 0.99 [0.02, 50.11]< 10%1 study (1/-)50.2 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 1.48 [0.11, 19.36]< 10%2 studies (2/-)38.3 %some concernnot evaluable moderatenon important-
Pyrexia TRAE (grade 3-4) 1.00 [0.02, 50.69]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 2.92 [0.30, 28.85]< 10%2 studies (2/-)18.1 %lownot evaluable highnon important-
Renal and urinary disorders TRAE (grade 3-4) 8.01 [0.42, 152.12]< 10%1 study (1/-)8.5 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 5.99 [0.30, 120.06]< 10%1 study (1/-)12.4 %NAnot evaluable non important-
Thyroiditis TRAE (grade 3-4) 1.00 [0.06, 15.97]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
Urticaria TRAE (grade 3-4) 0.99 [0.02, 50.11]< 10%1 study (1/-)50.2 %NAnot evaluable non important-
Uveitis TRAE (grade 3-4) 1.00 [0.02, 50.69]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Vitiligo TRAE (grade 3-4) 1.00 [0.02, 50.69]< 10%1 study (1/-)49.9 %NAnot evaluable non important-

AE (grade 3-4) endpoints 00

hepatitis (Autoimmune) AE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 1.32 [0.57, 3.04]< 10%1 study (1/-)26.1 %NAnot evaluable non important-
Arthralgia AE (grade 3-4) 4.03 [0.18, 89.68]< 10%1 study (1/-)19.2 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.12 [0.01, 2.36]< 10%1 study (1/-)91.5 %NAnot evaluable non important-
Back pain AE (grade 3-4) 0.50 [0.15, 1.66]< 10%1 study (1/-)87.2 %NAnot evaluable non important-
Constipation AE (grade 3-4) 4.03 [0.18, 89.68]< 10%1 study (1/-)19.2 %NAnot evaluable non important-
Cough AE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 0.50 [0.05, 5.54]< 10%1 study (1/-)71.2 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 2.01 [0.18, 22.29]< 10%1 study (1/-)28.6 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 3.04 [0.61, 15.19]< 10%1 study (1/-)8.8 %NAnot evaluable non important-
Hypothyroidism AE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Infusion-related reaction AE (grade 3-4) 6.06 [0.30, 121.47]< 10%1 study (1/-)12.2 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.50 [0.05, 5.54]< 10%1 study (1/-)71.2 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Rash AE (grade 3-4) 2.01 [0.07, 60.08]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Skin and subcutaneous tissue disorders AE (grade 3-4) 12.09 [0.67, 217.24]< 10%1 study (1/-)4.7 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 2.02 [0.37, 11.09]< 10%1 study (1/-)21.1 %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.