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hepatocell cancer (HCC), pembrolizumab 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) 0.78 [0.61, 1.00]< 10%1 study (1/-)97.6 %NAnot evaluable crucial-
progression or deaths (PFS) 0.72 [0.57, 0.90]< 10%1 study (1/-)99.8 %NAnot evaluable important-
DCR 1.44 [0.95, 2.19]> 10%1 study (1/-)95.8 %NAnot evaluable non important-
objective responses (ORR) 4.83 [2.02, 11.57]> 10%1 study (1/-)100.0 %NAnot evaluable non important-

safety endpoints 00

AE (any grade) 2.89 [1.23, 6.77]< 10%1 study (1/-)0.7 %NAnot evaluable non important-
AE (grade 3-4) 1.26 [0.83, 1.90]< 10%1 study (1/-)13.9 %NAnot evaluable non important-
AE leading to death (grade 5) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
AE leading to treatment discontinuation (any grade) 2.11 [1.08, 4.13]< 10%1 study (1/-)1.4 %NAnot evaluable non important-
AE leading to treatment discontinuation (grade 3-4) 3.04 [1.32, 6.97]< 10%1 study (1/-)0.4 %NAnot evaluable non important-
TRAE (any grade) 1.66 [1.09, 2.51]< 10%1 study (1/-)0.9 %NAnot evaluable non important-
TRAE (grade 3-4) 2.77 [1.36, 5.65]< 10%1 study (1/-)0.3 %NAnot evaluable non important-
TRAE leading to death (grade 5) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Alopecia TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 0.24 [0.02, 2.64]< 10%1 study (1/-)87.7 %NAnot evaluable non important-
Arthralgia TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 1.93 [0.09, 43.05]< 10%1 study (1/-)34.1 %NAnot evaluable non important-
Constipation TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Cough TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Decreased appetite TRAE (grade 3-4) 2.90 [0.14, 58.35]< 10%1 study (1/-)24.6 %NAnot evaluable non important-
Diabetes TRAE (grade 3-4) 0.48 [0.03, 7.71]< 10%1 study (1/-)69.7 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 0.96 [0.09, 10.69]< 10%1 study (1/-)51.3 %NAnot evaluable non important-
Dry skin TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Dysgeusia TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Dyspepsia TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Dyspnoea TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Eczema TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 1.45 [0.15, 14.03]< 10%1 study (1/-)37.6 %NAnot evaluable non important-
Headache TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 3.88 [0.20, 74.00]< 10%1 study (1/-)18.6 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Hypophysitis TRAE (grade 3-4) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-
Increase AST TRAE (grade 3-4) 3.75 [0.85, 16.64]< 10%1 study (1/-)4.2 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 2.45 [0.53, 11.36]< 10%1 study (1/-)12.6 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 0.24 [0.01, 7.16]< 10%1 study (1/-)79.2 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Myalgia TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Myositis TRAE (grade 3-4) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-
Peripheral oedema TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 1.93 [0.09, 43.05]< 10%1 study (1/-)34.1 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-
Pyrexia TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 5.87 [0.33, 105.85]< 10%1 study (1/-)11.8 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Thyroiditis TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Weight decreased TRAE (grade 3-4) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 3.88 [0.20, 74.00]< 10%1 study (1/-)18.6 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 0.42 [0.18, 0.97]< 10%1 study (1/-)97.8 %NAnot evaluable non important-
Arthralgia AE (grade 3-4) 0.48 [0.03, 7.71]< 10%1 study (1/-)69.7 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Back pain AE (grade 3-4) 3.88 [0.20, 74.00]< 10%1 study (1/-)18.6 %NAnot evaluable non important-
Constipation AE (grade 3-4) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-
Cough AE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 2.90 [0.14, 58.35]< 10%1 study (1/-)24.6 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 0.64 [0.14, 2.88]< 10%1 study (1/-)72.1 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 0.12 [0.01, 2.65]< 10%1 study (1/-)90.8 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 1.70 [0.35, 8.29]< 10%1 study (1/-)25.7 %NAnot evaluable non important-
Increase AST AE (grade 3-4) 1.90 [0.91, 3.94]< 10%1 study (1/-)4.3 %NAnot evaluable non important-
Increased ALT AE (grade 3-4) 2.11 [0.70, 6.39]< 10%1 study (1/-)9.4 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.96 [0.09, 10.69]< 10%1 study (1/-)51.3 %NAnot evaluable non important-
Peripheral oedema AE (grade 3-4) 0.48 [0.01, 24.29]< 10%1 study (1/-)64.1 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 0.96 [0.03, 28.81]< 10%1 study (1/-)50.9 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 1.93 [0.09, 43.05]< 10%1 study (1/-)34.1 %NAnot evaluable non important-
Rash AE (grade 3-4) 1.93 [0.09, 43.05]< 10%1 study (1/-)34.1 %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.