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metastatic/advanced NSCLC (mNSCLC) - 1st line (L1), immune chekpoint inhibitors versus pemetrexed plus platin, 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) 0.79 [0.68, 0.92]< 10%3 studies (3/-)99.9 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.71 [0.45, 1.12]< 10%1 study (1/-)92.9 %NAnot evaluable important-
PFS (extension) 0.54 [0.35, 0.83]< 10%1 study (1/-)99.7 %NAnot evaluable important-
progression or deaths (PFS) 0.71 [0.59, 0.85]< 137%4 studies (4/-)100.0 %some concernnot evaluable moderateimportant-
objective responses (ORR) 1.93 [1.16, 3.20]> 170%3 studies (3/-)99.4 %some concernnot evaluable moderatenon important-
objective responses (ORR) (extension) 2.80 [1.34, 5.83]> 10%1 study (1/-)99.7 %NAnot evaluable non important-

safety endpoints 00

STRAE (any grade) 2.12 [1.63, 2.76]< 10%4 studies (4/-)0.0 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 2.14 [1.60, 2.87]< 10%4 studies (4/-)0.0 %some concernnot evaluable moderatenon important-
TRAE (any grade) 1.28 [0.58, 2.81]< 184%4 studies (4/-)26.8 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 1.42 [0.87, 2.31]< 178%4 studies (4/-)8.0 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.20 [0.44, 3.23]< 10%3 studies (3/-)36.1 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 1.76 [0.82, 3.79]< 181%4 studies (4/-)7.5 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (grade 3-4) 2.50 [0.95, 6.59]< 178%4 studies (4/-)3.2 %some concernnot evaluable moderatenon important-

TRAE (grade 3-4) endpoints 00

Acute kidney injury TRAE (grade 3-4) 4.32 [0.19, 97.73]< 10%1 study (1/-)18.2 %NAnot evaluable non important-
Alopecia TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 0.43 [0.12, 1.49]< 186%4 studies (4/-)90.7 %some concernnot evaluable moderatenon important-
Asthenia TRAE (grade 3-4) 1.20 [0.46, 3.13]< 10%3 studies (3/-)35.7 %some concernnot evaluable moderatenon important-
Blood creatinine increased TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Constipation TRAE (grade 3-4) 0.57 [0.10, 3.32]< 10%4 studies (4/-)73.5 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 0.92 [0.37, 2.27]< 10%4 studies (4/-)57.1 %some concernnot evaluable moderatenon important-
Diarrhoea TRAE (grade 3-4) 1.72 [0.65, 4.59]< 10%4 studies (4/-)13.9 %some concernnot evaluable moderatenon important-
Dizziness TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Dysgeusia TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 1.70 [0.78, 3.74]< 12%4 studies (4/-)9.2 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 2.12 [0.07, 64.42]< 10%1 study (1/-)33.5 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 1.11 [0.07, 17.94]< 10%2 studies (2/-)47.0 %some concernnot evaluable moderatenon important-
Increase AST TRAE (grade 3-4) 1.05 [0.06, 17.21]< 10%1 study (1/-)48.6 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 1.05 [0.06, 17.21]< 10%1 study (1/-)48.6 %NAnot evaluable non important-
Increased lacrimation (TRAE grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 2.12 [0.07, 64.42]< 10%1 study (1/-)33.5 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 2.12 [0.07, 64.42]< 10%1 study (1/-)33.5 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 0.68 [0.28, 1.64]< 10%4 studies (4/-)80.3 %some concernnot evaluable moderatenon important-
Neutropenia TRAE (grade 3-4) 0.22 [0.02, 2.28]< 181%4 studies (4/-)89.6 %some concernnot evaluable moderatenon important-
Pancytopenia TRAE (grade 3-4) 0.52 [0.02, 15.84]< 10%1 study (1/-)64.4 %NAnot evaluable non important-
Peripheral oedema TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Pneumonia TRAE (grade 3-4) 2.12 [0.07, 64.42]< 10%1 study (1/-)33.5 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 2.12 [0.07, 64.42]< 10%1 study (1/-)33.5 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 2.53 [0.45, 14.15]< 10%4 studies (4/-)14.7 %some concernnot evaluable moderatenon important-
Rash TRAE (grade 3-4) 5.69 [1.18, 27.31]< 10%4 studies (4/-)1.5 %some concernnot evaluable moderatenon important-
Sepsis TRAE (grade 3-4) 2.12 [0.07, 64.42]< 10%1 study (1/-)33.5 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 1.05 [0.06, 17.21]< 10%1 study (1/-)48.6 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 0.52 [0.02, 15.84]< 10%1 study (1/-)64.4 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 1.05 [0.14, 7.73]< 10%1 study (1/-)48.0 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.45 [0.10, 1.97]< 148%4 studies (4/-)85.6 %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.