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Extensive stage SCLC (Es-SCLC) - 1st Line (L1), pembrolizumab plus SoC , 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 [0.65, 0.99]< 10%1 study (1/-)98.0 %NAnot evaluable crucial-
progression or deaths (PFS) 0.75 [0.61, 0.92]< 10%1 study (1/-)99.8 %NAnot evaluable important-
objective responses (ORR) 1.49 [1.01, 2.21]> 10%1 study (1/-)97.7 %NAnot evaluable non important-

safety endpoints 00

AE (grade 3-4) 1.12 [0.73, 1.73]< 10%1 study (1/-)30.2 %NAnot evaluable non important-
AE leading to death (grade 5) 1.27 [0.56, 2.87]< 10%1 study (1/-)28.0 %NAnot evaluable non important-
AE leading to treatment discontinuation (any grade) 2.64 [1.38, 5.07]< 10%1 study (1/-)0.2 %NAnot evaluable non important-
TRAE (any grade) 2.05 [0.69, 6.09]< 10%1 study (1/-)9.9 %NAnot evaluable non important-
TRAE (grade 3-4) 1.12 [0.76, 1.65]< 10%1 study (1/-)27.9 %NAnot evaluable non important-
TRAE leading to death (grade 5) 1.00 [0.32, 3.15]< 10%1 study (1/-)50.0 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Adrenal insufficiency TRAE (grade 3-4) 4.03 [0.18, 89.81]< 10%1 study (1/-)19.3 %NAnot evaluable non important-
Alopecia TRAE (grade 3-4) 0.50 [0.02, 14.95]< 10%1 study (1/-)65.4 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 1.08 [0.63, 1.86]< 10%1 study (1/-)39.1 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 0.49 [0.12, 2.00]< 10%1 study (1/-)83.8 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 0.50 [0.04, 5.53]< 10%1 study (1/-)71.4 %NAnot evaluable non important-
Constipation TRAE (grade 3-4) 0.25 [0.01, 5.54]< 10%1 study (1/-)80.7 %NAnot evaluable non important-
Decreased appetite TRAE (grade 3-4) 0.12 [0.01, 2.34]< 10%1 study (1/-)91.6 %NAnot evaluable non important-
Diabetes TRAE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 1.68 [0.40, 7.12]< 10%1 study (1/-)24.1 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 4.05 [0.45, 36.57]< 10%1 study (1/-)10.8 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 6.07 [0.30, 121.85]< 10%1 study (1/-)12.2 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Hypophysitis TRAE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 1.27 [0.69, 2.33]< 10%1 study (1/-)22.1 %NAnot evaluable non important-
Myocarditis TRAE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non 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) 1.00 [0.14, 7.16]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Nephritis TRAE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Neutropenia TRAE (grade 3-4) 1.04 [0.71, 1.51]< 10%1 study (1/-)42.4 %NAnot evaluable non important-
Pancreatitis TRAE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 6.07 [0.30, 121.85]< 10%1 study (1/-)12.2 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 8.13 [0.43, 154.66]< 10%1 study (1/-)8.4 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 1.18 [0.67, 2.09]< 10%1 study (1/-)28.1 %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) 0.66 [0.11, 4.01]< 10%1 study (1/-)67.2 %NAnot evaluable non important-

AE (grade 3-4) endpoints 00

Alopecia AE (grade 3-4) 0.50 [0.02, 14.95]< 10%1 study (1/-)65.4 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 1.03 [0.62, 1.73]< 10%1 study (1/-)44.8 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.72 [0.28, 1.82]< 10%1 study (1/-)75.8 %NAnot evaluable non important-
Back pain AE (grade 3-4) 2.00 [0.07, 60.06]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Constipation AE (grade 3-4) 0.50 [0.04, 5.53]< 10%1 study (1/-)71.4 %NAnot evaluable non important-
Cough AE (grade 3-4) 0.50 [0.04, 5.53]< 10%1 study (1/-)71.4 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 0.25 [0.03, 2.22]< 10%1 study (1/-)89.2 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 1.00 [0.32, 3.15]< 10%1 study (1/-)50.0 %NAnot evaluable non 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) 0.75 [0.17, 3.37]< 10%1 study (1/-)64.7 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 1.51 [0.42, 5.44]< 10%1 study (1/-)26.3 %NAnot evaluable non important-
Headache AE (grade 3-4) 0.50 [0.02, 14.95]< 10%1 study (1/-)65.4 %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-
Leucopenia AE (grade 3-4) 1.27 [0.69, 2.33]< 10%1 study (1/-)22.1 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.66 [0.11, 4.01]< 10%1 study (1/-)67.2 %NAnot evaluable non important-
Neutropenia AE (grade 3-4) 1.12 [0.77, 1.63]< 10%1 study (1/-)28.3 %NAnot evaluable non 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) 1.54 [0.67, 3.50]< 10%1 study (1/-)15.3 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 1.00 [0.06, 16.09]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Rash AE (grade 3-4) 6.07 [0.30, 121.85]< 10%1 study (1/-)12.2 %NAnot evaluable non important-
Thrombocytopenia AE (grade 3-4) 1.28 [0.73, 2.25]< 10%1 study (1/-)19.6 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 0.50 [0.09, 2.73]< 10%1 study (1/-)78.9 %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.