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renal cell cancer (RCC), avelumab based treatment , 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 [0.62, 1.03]< 10%1 study (1/-)95.6 %NAnot evaluable crucial-
PFS (extension) 0.69 [0.58, 0.83]< 10%1 study (1/-)100.0 %NAnot evaluable important-
progression or deaths (PFS) 0.69 [0.56, 0.85]< 10%1 study (1/-)100.0 %NAnot evaluable important-
objective responses (ORR) 2.95 [2.23, 3.90]> 10%1 study (1/-)100.0 %NAnot evaluable non important-

safety endpoints 00

AE (grade 3-4) 0.98 [0.73, 1.32]< 10%1 study (1/-)54.3 %NAnot evaluable non important-
AE leading to death (grade 5) 3.05 [0.32, 29.42]< 10%1 study (1/-)16.9 %NAnot evaluable non important-
AE leading to treatment discontinuation (any grade) 0.53 [0.34, 0.83]< 10%1 study (1/-)99.7 %NAnot evaluable non important-
TRAE (any grade) 0.78 [0.40, 1.53]< 10%1 study (1/-)76.2 %NAnot evaluable non important-
TRAE (grade 3-4) 1.06 [0.81, 1.38]< 10%1 study (1/-)34.6 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Anaemia TRAE (grade 3-4) 0.04 [0.01, 0.33]< 10%1 study (1/-)99.9 %NAnot evaluable non important-
Arthralgia TRAE (grade 3-4) 2.03 [0.07, 60.53]< 10%1 study (1/-)34.4 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 0.63 [0.20, 1.93]< 10%1 study (1/-)79.1 %NAnot evaluable non important-
Chills TRAE (grade 3-4) 2.03 [0.07, 60.53]< 10%1 study (1/-)34.4 %NAnot evaluable non important-
Decreased appetite TRAE (grade 3-4) 1.78 [0.52, 6.13]< 10%1 study (1/-)18.0 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 2.08 [0.99, 4.34]< 10%1 study (1/-)2.6 %NAnot evaluable non important-
Dysgeusia TRAE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Dyspepsia TRAE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Dysphonia TRAE (grade 3-4) 4.06 [0.18, 90.30]< 10%1 study (1/-)19.1 %NAnot evaluable non important-
Dyspnoea TRAE (grade 3-4) 6.14 [0.74, 51.22]< 10%1 study (1/-)4.8 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 0.82 [0.39, 1.72]< 10%1 study (1/-)70.3 %NAnot evaluable non important-
Hypertension TRAE (grade 3-4) 1.79 [1.28, 2.52]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 1.01 [0.06, 16.22]< 10%1 study (1/-)49.7 %NAnot evaluable non important-
Increase AST TRAE (grade 3-4) 2.05 [0.76, 5.52]< 10%1 study (1/-)7.7 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 2.43 [1.10, 5.37]< 10%1 study (1/-)1.4 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 14.38 [0.81, 254.14]< 10%1 study (1/-)3.6 %NAnot evaluable non important-
Mucosal inflammation TRAE (grade 3-4) 1.27 [0.34, 4.75]< 10%1 study (1/-)36.3 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 0.60 [0.14, 2.54]< 10%1 study (1/-)75.3 %NAnot evaluable non important-
Neutropenia TRAE (grade 3-4) 0.03 [0.00, 0.20]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 1.35 [0.73, 2.49]< 10%1 study (1/-)16.8 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 1.01 [0.14, 7.21]< 10%1 study (1/-)49.5 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 2.04 [0.61, 6.83]< 10%1 study (1/-)12.4 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 0.04 [0.01, 0.30]< 10%1 study (1/-)99.9 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.14 [0.02, 1.16]< 10%1 study (1/-)96.5 %NAnot evaluable non important-
Weight decreased TRAE (grade 3-4) 7.18 [0.88, 58.61]< 10%1 study (1/-)3.4 %NAnot evaluable non important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 0.63 [0.20, 1.93]< 10%1 study (1/-)79.1 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 0.18 [0.08, 0.42]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Arthralgia AE (grade 3-4) 2.03 [0.37, 11.16]< 10%1 study (1/-)20.8 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.85 [0.38, 1.92]< 10%1 study (1/-)65.0 %NAnot evaluable non important-
Back pain AE (grade 3-4) 0.25 [0.05, 1.18]< 10%1 study (1/-)95.9 %NAnot evaluable non important-
Chills AE (grade 3-4) 2.03 [0.07, 60.53]< 10%1 study (1/-)34.4 %NAnot evaluable non important-
Constipation AE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Cough AE (grade 3-4) 2.03 [0.07, 60.53]< 10%1 study (1/-)34.4 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 2.30 [0.70, 7.54]< 10%1 study (1/-)8.4 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 2.55 [1.28, 5.06]< 10%1 study (1/-)0.4 %NAnot evaluable non important-
Dizziness AE (grade 3-4) 0.67 [0.11, 4.05]< 10%1 study (1/-)66.7 %NAnot evaluable non important-
Dry skin AE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Dysgeusia AE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Dyspepsia AE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Dysphonia AE (grade 3-4) 4.06 [0.18, 90.30]< 10%1 study (1/-)19.1 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 1.91 [0.75, 4.82]< 10%1 study (1/-)8.7 %NAnot evaluable non important-
Epistaxis AE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 0.95 [0.46, 1.94]< 10%1 study (1/-)56.0 %NAnot evaluable non important-
Headache AE (grade 3-4) 1.01 [0.06, 16.22]< 10%1 study (1/-)49.7 %NAnot evaluable non important-
Hypertension AE (grade 3-4) 1.67 [1.20, 2.32]< 10%1 study (1/-)0.1 %NAnot evaluable non important-
Hypothyroidism AE (grade 3-4) 1.01 [0.06, 16.22]< 10%1 study (1/-)49.7 %NAnot evaluable non important-
Increase AST AE (grade 3-4) 1.95 [0.86, 4.42]< 10%1 study (1/-)5.5 %NAnot evaluable non important-
Increased ALT AE (grade 3-4) 2.48 [1.21, 5.08]< 10%1 study (1/-)0.7 %NAnot evaluable non important-
Mucosal inflammation AE (grade 3-4) 1.01 [0.29, 3.52]< 10%1 study (1/-)49.3 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.87 [0.29, 2.60]< 10%1 study (1/-)60.2 %NAnot evaluable non important-
Neutropenia AE (grade 3-4) 0.03 [0.00, 0.20]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Oropharyngeal pain AE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Palmar–plantar erythrodysesthesia syndrome AE (grade 3-4) 1.35 [0.73, 2.49]< 10%1 study (1/-)16.8 %NAnot evaluable non important-
Peripheral oedema AE (grade 3-4) 2.03 [0.18, 22.45]< 10%1 study (1/-)28.4 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 1.01 [0.02, 51.10]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 0.51 [0.02, 15.10]< 10%1 study (1/-)65.1 %NAnot evaluable non important-
Rash AE (grade 3-4) 1.01 [0.14, 7.21]< 10%1 study (1/-)49.5 %NAnot evaluable non important-
Stomatitis AE (grade 3-4) 2.04 [0.61, 6.83]< 10%1 study (1/-)12.4 %NAnot evaluable non important-
Thrombocytopenia AE (grade 3-4) 0.04 [0.00, 0.26]< 10%1 study (1/-)99.9 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 0.57 [0.17, 1.98]< 10%1 study (1/-)81.0 %NAnot evaluable non important-
Weight decreased AE (grade 3-4) 3.09 [0.99, 9.66]< 10%1 study (1/-)2.6 %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.