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Extensive stage SCLC (Es-SCLC) - 1st Line (L1), anti-PD-(L)1 , 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) 0.75 [0.66, 0.85]< 10%3 studies (3/-)100.0 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.75 [0.65, 0.87]< 10%2 studies (2/-)100.0 %some concernnot evaluable moderateimportant-
PFS (extension) 0.79 [0.68, 0.90]< 10%2 studies (2/-)100.0 %some concernnot evaluable moderateimportant-
progression or deaths (PFS) 0.77 [0.68, 0.86]< 10%3 studies (3/-)100.0 %lownot evaluable highimportant-
objective responses (ORR) 1.27 [0.85, 1.91]> 168%3 studies (3/-)87.7 %lownot evaluable highnon important-
objective responses (ORR) (extension) 0.84 [0.56, 1.25]> 10%1 study (1/-)19.5 %NAnot evaluable non important-

safety endpoints 00

AE (any grade) 3.21 [0.43, 23.85]< 149%2 studies (2/-)12.8 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 1.06 [0.85, 1.33]< 10%3 studies (3/-)30.0 %lownot evaluable highnon important-
AE leading to death (grade 5) 0.81 [0.42, 1.55]< 138%3 studies (3/-)74.0 %lownot evaluable highnon important-
AE leading to treatment discontinuation (any grade) 2.08 [0.92, 4.69]< 175%3 studies (3/-)3.9 %lownot evaluable highnon important-
AE leading to treatment discontinuation (grade 3-4) 1.00 [0.35, 2.90]< 10%1 study (1/-)49.7 %NAnot evaluable non important-
SAE (any grade) 0.93 [0.66, 1.31]< 135%2 studies (2/-)66.1 %some concernnot evaluable moderatenon important-
SAE (grade 3-4) 0.77 [0.51, 1.15]< 10%1 study (1/-)90.3 %NAnot evaluable non important-
STRAE (any grade) 0.91 [0.48, 1.72]< 172%2 studies (2/-)61.6 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 0.51 [0.30, 0.86]< 10%1 study (1/-)99.4 %NAnot evaluable non important-
TRAE (any grade) 1.22 [0.77, 1.92]< 18%3 studies (3/-)20.0 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 0.95 [0.76, 1.18]< 16%3 studies (3/-)69.1 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 1.25 [0.55, 2.82]< 10%3 studies (3/-)29.5 %lownot evaluable highnon important-
TRAE leading to discontinuation (any grade) 1.17 [0.54, 2.50]< 10%1 study (1/-)34.5 %NAnot evaluable non important-
TRAE leading to discontinuation (grade 3-4) 0.75 [0.17, 3.38]< 10%1 study (1/-)64.5 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Acute kidney injury TRAE (grade 3-4) 3.99 [0.18, 89.04]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 1.85 [0.23, 14.67]< 10%3 studies (3/-)28.1 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 1.16 [0.27, 5.04]< 10%3 studies (3/-)42.3 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 0.87 [0.52, 1.45]< 160%3 studies (3/-)70.5 %lownot evaluable highnon important-
Arthritis TRAE (grade 3-4) 1.00 [0.02, 50.78]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 0.63 [0.20, 1.96]< 10%2 studies (2/-)78.9 %lownot evaluable highnon important-
Colitis TRAE (grade 3-4) 1.11 [0.15, 8.06]< 17%2 studies (2/-)46.0 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 0.72 [0.10, 5.19]< 10%3 studies (3/-)62.9 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 0.76 [0.11, 5.28]< 123%3 studies (3/-)60.8 %lownot evaluable highnon important-
Diabetes TRAE (grade 3-4) 3.09 [0.45, 21.45]< 10%3 studies (3/-)12.8 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 1.77 [0.63, 4.94]< 10%3 studies (3/-)13.9 %lownot evaluable highnon important-
Fatigue TRAE (grade 3-4) 1.70 [0.52, 5.57]< 10%3 studies (3/-)19.1 %lownot evaluable highnon important-
Febrile neutropenia TRAE (grade 3-4) 0.64 [0.35, 1.17]< 10%2 studies (2/-)92.7 %some concernnot evaluable moderatenon important-
Guillain-Barré syndrome TRAE (grade 3-4) 1.98 [0.07, 59.51]< 10%1 study (1/-)34.9 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 6.04 [0.72, 50.41]< 10%2 studies (2/-)4.9 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 1.32 [0.15, 11.31]< 10%3 studies (3/-)40.1 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 1.00 [0.10, 9.62]< 10%3 studies (3/-)50.1 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 1.00 [0.10, 9.62]< 10%3 studies (3/-)50.1 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 8.25 [1.02, 66.42]< 10%1 study (1/-)2.4 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 4.02 [0.45, 36.30]< 10%1 study (1/-)10.9 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 1.20 [0.79, 1.83]< 10%3 studies (3/-)19.7 %lownot evaluable highnon important-
Myocarditis TRAE (grade 3-4) 1.00 [0.06, 16.06]< 10%2 studies (2/-)49.9 %some concernnot evaluable moderatenon important-
Myositis TRAE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 0.58 [0.14, 2.37]< 10%3 studies (3/-)77.5 %lownot evaluable highnon important-
Nephritis TRAE (grade 3-4) 1.99 [0.18, 22.08]< 10%2 studies (2/-)28.8 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.83 [0.61, 1.14]< 144%3 studies (3/-)87.1 %lownot evaluable highnon important-
Pancreatitis TRAE (grade 3-4) 0.79 [0.11, 5.62]< 10%2 studies (2/-)59.4 %lownot evaluable highnon important-
Pancytopenia TRAE (grade 3-4) 0.33 [0.03, 3.17]< 10%1 study (1/-)83.1 %NAnot evaluable non important-
Paraesthesia TRAE (grade 3-4) 1.00 [0.02, 50.78]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 3.99 [0.18, 89.04]< 10%1 study (1/-)19.4 %NAnot evaluable non important-
Pneumonia TRAE (grade 3-4) 6.02 [0.30, 120.88]< 10%1 study (1/-)12.3 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 1.55 [0.35, 6.80]< 10%3 studies (3/-)28.2 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 1.00 [0.02, 50.78]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 3.80 [0.36, 40.13]< 10%2 studies (2/-)13.5 %lownot evaluable highnon important-
Severe skin reaction TRAE (grade 3-4) 3.81 [0.36, 40.15]< 10%2 studies (2/-)13.5 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 0.98 [0.58, 1.63]< 147%3 studies (3/-)53.7 %lownot evaluable highnon important-
Thyroiditis TRAE (grade 3-4) 1.00 [0.02, 50.78]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Uveitis TRAE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.57 [0.18, 1.86]< 10%3 studies (3/-)82.2 %lownot evaluable highnon important-

AE (grade 3-4) endpoints 00

Alopecia AE (grade 3-4) 1.19 [0.24, 5.81]< 10%2 studies (2/-)41.7 %some concernnot evaluable moderatenon important-
Anaemia AE (grade 3-4) 0.69 [0.30, 1.54]< 180%2 studies (2/-)81.9 %lownot evaluable highnon important-
Asthenia AE (grade 3-4) 0.92 [0.42, 2.01]< 10%2 studies (2/-)58.1 %lownot evaluable highnon important-
Back pain AE (grade 3-4) 2.01 [0.28, 14.34]< 10%2 studies (2/-)24.4 %some concernnot evaluable moderatenon important-
Constipation AE (grade 3-4) 1.12 [0.15, 8.23]< 18%2 studies (2/-)45.7 %lownot evaluable highnon important-
Cough AE (grade 3-4) 1.12 [0.15, 8.23]< 18%2 studies (2/-)45.7 %lownot evaluable highnon important-
Decreased appetite AE (grade 3-4) 0.54 [0.12, 2.33]< 10%2 studies (2/-)79.6 %some concernnot evaluable moderatenon important-
Diarrhoea AE (grade 3-4) 1.00 [0.39, 2.55]< 10%2 studies (2/-)49.9 %lownot evaluable highnon important-
Dizziness AE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 1.14 [0.40, 3.24]< 10%2 studies (2/-)40.1 %some concernnot evaluable moderatenon important-
Fatigue AE (grade 3-4) 1.44 [0.54, 3.82]< 10%2 studies (2/-)23.2 %lownot evaluable highnon important-
Febrile neutropenia AE (grade 3-4) 0.82 [0.39, 1.69]< 10%1 study (1/-)70.7 %NAnot evaluable non important-
Headache AE (grade 3-4) 1.00 [0.09, 11.09]< 10%2 studies (2/-)49.9 %some concernnot evaluable moderatenon important-
Hypertension AE (grade 3-4) 8.25 [1.02, 66.42]< 10%1 study (1/-)2.4 %NAnot evaluable non important-
Hyperthyroidism AE (grade 3-4) 1.00 [0.02, 50.78]< 10%1 study (1/-)49.9 %NAnot evaluable non important-
Hypothyroidism AE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Increased Lipase Level AE (grade 3-4) 2.30 [0.70, 7.57]< 10%1 study (1/-)8.5 %NAnot evaluable non important-
Leucopenia AE (grade 3-4) 1.25 [0.79, 2.00]< 10%2 studies (2/-)17.0 %lownot evaluable highnon important-
Nausea AE (grade 3-4) 0.40 [0.10, 1.61]< 10%2 studies (2/-)90.1 %lownot evaluable highnon important-
Neutropenia AE (grade 3-4) 0.85 [0.49, 1.46]< 175%2 studies (2/-)72.4 %lownot evaluable highnon important-
Peripheral oedema AE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Pneumonia AE (grade 3-4) 0.98 [0.36, 2.67]< 153%2 studies (2/-)51.2 %lownot evaluable highnon important-
Pruritus AE (grade 3-4) 1.00 [0.06, 16.06]< 10%2 studies (2/-)49.9 %some concernnot evaluable moderatenon important-
Pyrexia AE (grade 3-4) 0.76 [0.09, 6.52]< 10%2 studies (2/-)59.9 %lownot evaluable highnon important-
Rash AE (grade 3-4) 3.12 [0.29, 33.87]< 10%2 studies (2/-)17.6 %lownot evaluable highnon important-
Thrombocytopenia AE (grade 3-4) 0.88 [0.40, 1.91]< 169%2 studies (2/-)62.9 %lownot evaluable highnon important-
Vomiting AE (grade 3-4) 0.38 [0.09, 1.67]< 10%2 studies (2/-)89.9 %lownot evaluable highnon 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.