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mML - (neo)adjuvant (NA), nivolumab 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) 0.87 [0.66, 1.14]< 10%1 study (1/-)84.1 %NAnot evaluable crucial-
MFS 0.73 [0.56, 0.96]< 10%1 study (1/-)98.8 %NAnot evaluable important-
RFS (extension) 0.71 [0.59, 0.85]< 10%1 study (1/-)100.0 %NAnot evaluable important-
RFS/DFS 0.61 [0.49, 0.75]< 10%3 studies (3/-)100.0 %lownot evaluable highimportant-

safety endpoints 00

AE (any grade) 0.49 [0.20, 1.23]< 10%1 study (1/-)93.6 %NAnot evaluable non important-
AE (grade 3-4) 0.28 [0.21, 0.37]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
AE leading to death (grade 5) 0.97 [0.06, 15.73]< 10%2 studies (2/-)50.8 %lownot evaluable highnon important-
AE leading to treatment discontinuation (any grade) 1.74 [0.07, 44.47]< 197%3 studies (3/-)37.0 %lownot evaluable highnon important-
AE leading to treatment discontinuation (grade 3-4) 1.73 [0.05, 61.70]< 197%3 studies (3/-)38.4 %lownot evaluable highnon important-
SAE (any grade) 2.18 [0.76, 6.21]< 171%2 studies (2/-)7.3 %lownot evaluable highnon important-
SAE (grade 3-4) 3.06 [1.65, 5.67]< 10%2 studies (2/-)0.0 %lownot evaluable highnon important-
STRAE (any grade) 5.79 [2.74, 12.21]< 10%2 studies (2/-)0.0 %lownot evaluable highnon important-
STRAE (grade 3-4) 5.30 [2.27, 12.38]< 10%2 studies (2/-)0.0 %lownot evaluable highnon important-
TRAE (any grade) 1.66 [0.18, 15.50]< 194%3 studies (3/-)33.0 %lownot evaluable highnon important-
TRAE (grade 3-4) 1.91 [0.12, 29.55]< 197%3 studies (3/-)32.4 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 0.53 [0.07, 4.21]< 10%3 studies (3/-)72.5 %lownot evaluable highnon important-
TRAE leading to discontinuation (any grade) 2.01 [0.06, 73.17]< 198%3 studies (3/-)35.4 %lownot evaluable highnon important-
TRAE leading to discontinuation (grade 3-4) 1.93 [0.04, 97.28]< 197%3 studies (3/-)37.4 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.74 [0.09, 6.38]< 10%3 studies (3/-)60.7 %lownot evaluable highnon important-
Acute kidney injury TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 0.69 [0.17, 2.85]< 10%3 studies (3/-)69.6 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Anaemia TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Arthralgia TRAE (grade 3-4) 0.71 [0.14, 3.63]< 10%3 studies (3/-)65.8 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 0.25 [0.03, 2.24]< 10%1 study (1/-)89.1 %NAnot evaluable non important-
Blood and lymphatic system disorders TRAE (grade 3-4) 3.02 [0.28, 33.13]< 10%2 studies (2/-)18.5 %lownot evaluable highnon important-
Blood creatinine increased TRAE (grade 3-4) 0.91 [0.02, 46.72]< 10%1 study (1/-)51.8 %NAnot evaluable non important-
Chills TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Colitis TRAE (grade 3-4) 3.11 [0.28, 34.14]< 10%2 studies (2/-)17.8 %lownot evaluable highnon important-
Cough TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Diabetes TRAE (grade 3-4) 1.23 [0.17, 8.82]< 10%3 studies (3/-)41.8 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 0.35 [0.07, 1.76]< 141%3 studies (3/-)89.7 %lownot evaluable highnon important-
Dizziness TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dysgeusia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dyspepsia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dyspnoea TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Endocrine disorders TRAE (grade 3-4) 4.00 [0.64, 25.16]< 10%2 studies (2/-)7.0 %lownot evaluable highnon important-
Eye disorders TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Fatigue TRAE (grade 3-4) 0.60 [0.14, 2.55]< 10%3 studies (3/-)75.7 %lownot evaluable highnon important-
Gastritis TRAE (grade 3-4) 2.32 [0.20, 26.84]< 10%2 studies (2/-)25.1 %lownot evaluable highnon important-
Gastrointestinal disorders TRAE (grade 3-4) 1.04 [0.04, 29.48]< 189%3 studies (3/-)49.0 %lownot evaluable highnon important-
General disorders and administration site conditions TRAE (grade 3-4) 2.32 [0.20, 26.84]< 10%2 studies (2/-)25.1 %lownot evaluable highnon important-
Headache TRAE (grade 3-4) 0.28 [0.05, 1.51]< 10%3 studies (3/-)92.9 %lownot evaluable highnon important-
Hepatitis TRAE (grade 3-4) 3.40 [0.79, 14.57]< 10%2 studies (2/-)5.0 %lownot evaluable highnon important-
Hepatobiliary disorders TRAE (grade 3-4) 1.42 [0.07, 29.90]< 191%3 studies (3/-)41.2 %lownot evaluable highnon important-
Hypersensitivity TRAE (grade 3-4) 2.01 [0.07, 59.97]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Hypertension TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 1.92 [0.31, 11.76]< 10%3 studies (3/-)24.2 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 0.29 [0.08, 1.03]< 10%3 studies (3/-)97.2 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 0.66 [0.11, 4.08]< 10%3 studies (3/-)67.1 %lownot evaluable highnon important-
Increase AST TRAE (grade 3-4) 1.04 [0.07, 14.37]< 184%3 studies (3/-)48.9 %lownot evaluable highnon important-
Increased ALT TRAE (grade 3-4) 1.55 [0.11, 22.65]< 189%3 studies (3/-)37.6 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 1.80 [0.56, 5.76]< 116%2 studies (2/-)16.2 %lownot evaluable highnon important-
Infusion-related reactions TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Leucopenia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Maculopapular rash TRAE (grade 3-4) 0.37 [0.04, 3.82]< 131%3 studies (3/-)79.6 %lownot evaluable highnon important-
Metabolism and nutrition disorders TRAE (grade 3-4) 1.29 [0.15, 11.24]< 10%2 studies (2/-)40.9 %lownot evaluable highnon important-
Musculoskeletal and connective tissue disorders TRAE (grade 3-4) 0.96 [0.03, 31.61]< 163%2 studies (2/-)50.8 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 0.96 [0.09, 10.77]< 10%2 studies (2/-)51.2 %lownot evaluable highnon important-
Myositis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 1.29 [0.15, 11.14]< 10%3 studies (3/-)40.8 %lownot evaluable highnon important-
Nervous system disorders TRAE (grade 3-4) 1.07 [0.16, 7.27]< 10%2 studies (2/-)47.3 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Pancreatitis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Paraesthesia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Peripheral neuropathy TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Pneumonitis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 0.32 [0.04, 2.43]< 10%3 studies (3/-)86.2 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 0.99 [0.14, 6.74]< 10%3 studies (3/-)50.5 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 0.35 [0.13, 0.98]< 10%1 study (1/-)97.7 %NAnot evaluable non important-
Renal and urinary disorders TRAE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 0.37 [0.05, 2.77]< 10%3 studies (3/-)83.4 %lownot evaluable highnon important-
Sarcoidosis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 0.75 [0.09, 6.51]< 168%3 studies (3/-)60.2 %lownot evaluable highnon important-
Stomatitis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Thyroiditis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Uveitis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Vitiligo TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Vomiting TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Weight decreased TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %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.