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urothelial cancer (UC) - bladder cancer (BC), anti-PD-(L)1 versus platinum association, 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) 0.95 [0.85, 1.05]< 10%3 studies (3/-)83.8 %some concernnot evaluable moderatecrucial-
progression or deaths (PFS) 0.78 [0.66, 0.91]< 10%2 studies (2/-)99.9 %some concernnot evaluable moderateimportant-
DOR 0.27 [0.16, 0.44]< 135%2 studies (2/-)100.0 %some concernnot evaluable moderatenon important-
objective responses (ORR) 0.59 [0.23, 1.49]> 196%3 studies (3/-)13.2 %some concernnot evaluable moderatenon important-

safety endpoints 00

AE (any grade) 0.14 [0.05, 0.40]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
AE (grade 3-4) 0.21 [0.07, 0.65]< 195%2 studies (2/-)99.7 %some concernnot evaluable moderatenon important-
AE (grade 3-5) 1.53 [1.01, 2.33]< 10%1 study (1/-)2.3 %NAnot evaluable non important-
AE leading to death (grade 5) 2.36 [1.02, 5.43]< 167%2 studies (2/-)2.2 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 0.56 [0.12, 2.66]< 198%3 studies (3/-)76.5 %some concernnot evaluable moderatenon important-
SAE (any grade) 0.89 [0.69, 1.14]< 129%2 studies (2/-)82.7 %some concernnot evaluable moderatenon important-
STRAE (any grade) 0.62 [0.31, 1.24]< 189%3 studies (3/-)91.1 %some concernnot evaluable moderatenon important-
TRAE (any grade) 0.10 [0.05, 0.19]< 175%2 studies (2/-)100.0 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 0.18 [0.02, 1.31]< 199%3 studies (3/-)95.4 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.01 [0.35, 2.96]< 10%3 studies (3/-)48.9 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 0.46 [0.26, 0.79]< 10%1 study (1/-)99.7 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 3.64 [0.16, 81.12]< 10%1 study (1/-)21.0 %NAnot evaluable non important-
Acute kidney injury TRAE (grade 3-4) 0.45 [0.02, 13.55]< 10%1 study (1/-)67.4 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 1.41 [0.11, 18.39]< 10%2 studies (2/-)39.7 %some concernnot evaluable moderatenon important-
Alopecia TRAE (grade 3-4) 1.82 [0.06, 54.35]< 10%1 study (1/-)36.7 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 0.15 [0.02, 1.38]< 195%3 studies (3/-)95.2 %some concernnot evaluable moderatenon important-
Arthralgia TRAE (grade 3-4) 0.91 [0.02, 45.86]< 10%1 study (1/-)51.9 %NAnot evaluable non important-
Arthritis TRAE (grade 3-4) 0.91 [0.02, 45.86]< 10%1 study (1/-)51.9 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 0.66 [0.33, 1.33]< 14%3 studies (3/-)87.6 %some concernnot evaluable moderatenon important-
Blood creatinine increased TRAE (grade 3-4) 0.45 [0.02, 13.55]< 10%1 study (1/-)67.4 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 1.59 [0.20, 12.37]< 10%2 studies (2/-)32.9 %some concernnot evaluable moderatenon important-
Constipation TRAE (grade 3-4) 0.40 [0.04, 4.61]< 10%2 studies (2/-)76.5 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 0.73 [0.24, 2.22]< 10%3 studies (3/-)70.9 %some concernnot evaluable moderatenon important-
Diabetes TRAE (grade 3-4) 1.41 [0.11, 18.39]< 10%2 studies (2/-)39.7 %some concernnot evaluable moderatenon important-
Diarrhoea TRAE (grade 3-4) 0.80 [0.22, 2.93]< 142%2 studies (2/-)62.9 %some concernnot evaluable moderatenon important-
Dyspnoea TRAE (grade 3-4) 3.64 [0.16, 81.12]< 10%1 study (1/-)21.0 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 0.54 [0.18, 1.62]< 136%3 studies (3/-)86.5 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 0.15 [0.01, 3.01]< 10%1 study (1/-)89.0 %NAnot evaluable non important-
Gastritis TRAE (grade 3-4) 0.91 [0.02, 45.86]< 10%1 study (1/-)51.9 %NAnot evaluable non important-
Guillain-Barré syndrome TRAE (grade 3-4) 1.82 [0.06, 54.35]< 10%1 study (1/-)36.7 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 3.50 [0.37, 33.12]< 10%2 studies (2/-)13.9 %some concernnot evaluable moderatenon important-
Hypersensitivity TRAE (grade 3-4) 0.45 [0.02, 13.55]< 10%1 study (1/-)67.4 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 1.41 [0.11, 18.39]< 10%2 studies (2/-)39.7 %some concernnot evaluable moderatenon important-
Hypophysitis TRAE (grade 3-4) 2.97 [0.27, 32.10]< 10%2 studies (2/-)18.7 %some concernnot evaluable moderatenon important-
Hypothyroidism TRAE (grade 3-4) 2.24 [0.20, 25.51]< 10%2 studies (2/-)26.0 %some concernnot evaluable moderatenon important-
Increase AST TRAE (grade 3-4) 0.91 [0.13, 6.48]< 10%1 study (1/-)53.9 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 2.74 [0.28, 26.45]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Increased lipase level TRAE (grade 3-4) 6.46 [0.79, 52.82]< 10%1 study (1/-)4.2 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 0.91 [0.02, 45.86]< 10%1 study (1/-)51.9 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 0.22 [0.01, 3.62]< 175%2 studies (2/-)85.3 %some concernnot evaluable moderatenon important-
Myocarditis TRAE (grade 3-4) 2.75 [0.28, 27.20]< 10%2 studies (2/-)19.5 %some concernnot evaluable moderatenon important-
Myositis TRAE (grade 3-4) 1.39 [0.11, 18.19]< 10%2 studies (2/-)40.1 %some concernnot evaluable moderatenon important-
Nausea TRAE (grade 3-4) 0.37 [0.07, 1.86]< 141%3 studies (3/-)88.6 %some concernnot evaluable moderatenon important-
Nephritis TRAE (grade 3-4) 2.75 [0.28, 27.20]< 10%2 studies (2/-)19.5 %some concernnot evaluable moderatenon important-
Neutropenia TRAE (grade 3-4) 0.07 [0.00, 2.30]< 189%3 studies (3/-)93.0 %some concernnot evaluable moderatenon important-
Pancreatitis TRAE (grade 3-4) 2.24 [0.20, 25.51]< 10%2 studies (2/-)26.0 %some concernnot evaluable moderatenon important-
Pancytopenia TRAE (grade 3-4) 0.11 [0.01, 2.13]< 10%1 study (1/-)92.5 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 3.18 [0.51, 19.85]< 10%2 studies (2/-)10.9 %some concernnot evaluable moderatenon important-
Pruritic rash TRAE (grade 3-4) 0.91 [0.02, 45.86]< 10%1 study (1/-)51.9 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 2.65 [0.38, 18.62]< 10%3 studies (3/-)16.5 %some concernnot evaluable moderatenon important-
Pyrexia TRAE (grade 3-4) 0.23 [0.01, 5.02]< 10%1 study (1/-)82.3 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 3.98 [0.84, 18.82]< 10%3 studies (3/-)4.1 %some concernnot evaluable moderatenon important-
Sarcoidosis TRAE (grade 3-4) 0.98 [0.02, 49.53]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Sepsis TRAE (grade 3-4) 0.91 [0.06, 14.56]< 10%1 study (1/-)52.7 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 3.99 [0.84, 18.92]< 10%1 study (1/-)4.1 %NAnot evaluable non important-
Stevens-Johnson syndrome TRAE (grade 3-4) 1.82 [0.06, 54.35]< 10%1 study (1/-)36.7 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 0.91 [0.02, 45.86]< 10%1 study (1/-)51.9 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 0.14 [0.01, 1.49]< 183%3 studies (3/-)94.7 %some concernnot evaluable moderatenon important-
Thyroiditis TRAE (grade 3-4) 0.94 [0.06, 15.11]< 10%2 studies (2/-)51.6 %some concernnot evaluable moderatenon important-
Vomiting TRAE (grade 3-4) 0.46 [0.04, 4.83]< 161%2 studies (2/-)73.8 %some concernnot evaluable moderatenon important-

AE (grade 3-4) endpoints 00

Anaemia AE (grade 3-4) 0.08 [0.05, 0.13]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.51 [0.24, 1.10]< 10%1 study (1/-)95.7 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 0.22 [0.09, 0.54]< 10%1 study (1/-)99.9 %NAnot evaluable non important-
Febrile neutropenia AE (grade 3-4) 0.05 [0.00, 0.92]< 10%1 study (1/-)97.7 %NAnot evaluable non important-
Hypertension AE (grade 3-4) 0.54 [0.18, 1.61]< 10%1 study (1/-)86.4 %NAnot evaluable non important-
Leucopenia AE (grade 3-4) 0.02 [0.00, 0.25]< 10%1 study (1/-)99.8 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.08 [0.01, 0.58]< 10%1 study (1/-)99.3 %NAnot evaluable non important-
Neutropenia AE (grade 3-4) 0.00 [0.00, 0.05]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Thrombocytopenia AE (grade 3-4) 0.01 [0.00, 0.10]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 0.10 [0.01, 0.76]< 10%1 study (1/-)98.6 %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.