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mML - 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) 0.64 [0.49, 0.82]< 173%6 studies (6/-)100.0 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.63 [0.46, 0.85]< 184%3 studies (3/-)99.8 %lownot evaluable highimportant-
PFS (extension) 0.56 [0.40, 0.80]< 188%3 studies (3/-)99.9 %lownot evaluable highimportant-
progression or deaths (PFS) 0.64 [0.48, 0.86]< 189%6 studies (6/-)99.8 %lownot evaluable highimportant-
DCR 0.91 [0.63, 1.32]> 10%1 study (1/-)31.6 %NAnot evaluable non important-
DOR (extension) 3.45 [1.46, 8.18]> 10%1 study (1/-)99.8 %NAnot evaluable non important-
objective responses (ORR) 2.09 [1.23, 3.55]> 190%6 studies (6/-)99.7 %lownot evaluable highnon important-
objective responses (ORR) (extension) 4.57 [3.31, 6.32]> 150%3 studies (3/-)100.0 %lownot evaluable highnon important-

safety endpoints 00

AE (any grade) 3.12 [0.18, 53.89]< 191%2 studies (2/-)21.9 %lownot evaluable highnon important-
AE (grade 3-4) 1.84 [0.39, 8.56]< 197%2 studies (2/-)22.0 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.29 [0.60, 2.77]< 10%3 studies (3/-)26.2 %lownot evaluable highnon important-
AE leading to treatment discontinuation (any grade) 0.69 [0.46, 1.04]< 10%2 studies (2/-)96.4 %lownot evaluable highnon important-
AE leading to treatment discontinuation (grade 3-4) 0.61 [0.29, 1.28]< 10%1 study (1/-)90.5 %NAnot evaluable non important-
SAE (any grade) 0.73 [0.49, 1.10]< 10%1 study (1/-)93.1 %NAnot evaluable non important-
SAE (grade 3-4) 0.74 [0.47, 1.17]< 10%1 study (1/-)90.4 %NAnot evaluable non important-
STRAE (any grade) 1.20 [0.86, 1.66]< 10%2 studies (2/-)14.4 %lownot evaluable highnon important-
STRAE (grade 3-4) 0.99 [0.44, 2.27]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
TRAE (any grade) 1.37 [0.70, 2.68]< 177%4 studies (4/-)18.0 %lownot evaluable highnon important-
TRAE (grade 3-4) 1.33 [0.50, 3.54]< 196%4 studies (4/-)28.6 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 1.00 [0.06, 15.97]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
TRAE leading to discontinuation (any grade) 1.87 [0.29, 12.18]< 197%2 studies (2/-)25.7 %lownot evaluable highnon important-
TRAE leading to discontinuation (grade 3-4) 1.63 [0.17, 15.32]< 198%2 studies (2/-)33.6 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.72 [0.10, 5.18]< 10%3 studies (3/-)62.9 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 2.67 [0.70, 10.16]< 10%2 studies (2/-)7.6 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Arthralgia TRAE (grade 3-4) 1.52 [0.60, 3.87]< 10%4 studies (4/-)19.1 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 1.19 [0.37, 3.83]< 10%4 studies (4/-)38.5 %lownot evaluable highnon important-
Blood creatinine increased TRAE (grade 3-4) 0.61 [0.02, 18.27]< 10%1 study (1/-)61.1 %NAnot evaluable non important-
Chorioretinopathy TRAE (grade 3-4) 0.61 [0.02, 18.27]< 10%1 study (1/-)61.1 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 1.04 [0.01, 77.14]< 196%2 studies (2/-)49.3 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Cough TRAE (grade 3-4) 1.00 [0.15, 6.76]< 10%3 studies (3/-)50.1 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 1.16 [0.23, 6.02]< 10%4 studies (4/-)42.8 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 1.10 [0.33, 3.62]< 179%4 studies (4/-)43.7 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 1.74 [0.28, 10.82]< 10%4 studies (4/-)27.8 %lownot evaluable highnon important-
Dyspnoea TRAE (grade 3-4) 2.66 [0.40, 17.52]< 10%2 studies (2/-)15.6 %lownot evaluable highnon important-
Erythema TRAE (grade 3-4) 7.41 [0.37, 148.78]< 10%1 study (1/-)9.8 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 1.99 [0.66, 6.02]< 130%4 studies (4/-)11.3 %lownot evaluable highnon important-
Headache TRAE (grade 3-4) 1.39 [0.19, 10.03]< 10%3 studies (3/-)37.4 %lownot evaluable highnon important-
Hepatitis TRAE (grade 3-4) 4.45 [0.43, 46.06]< 10%2 studies (2/-)10.7 %lownot evaluable highnon important-
Hypersensitivity TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 3.19 [0.61, 16.63]< 10%4 studies (4/-)8.5 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 1.00 [0.04, 24.12]< 177%2 studies (2/-)50.1 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 1.32 [0.15, 11.29]< 10%3 studies (3/-)40.2 %lownot evaluable highnon important-
Increase AST TRAE (grade 3-4) 3.07 [0.94, 10.04]< 126%3 studies (3/-)3.2 %lownot evaluable highnon important-
Increased ALT TRAE (grade 3-4) 2.40 [0.50, 11.63]< 170%3 studies (3/-)13.9 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 1.41 [0.76, 2.62]< 167%3 studies (3/-)13.5 %lownot evaluable highnon important-
Infusion-related reactions TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 0.12 [0.01, 2.33]< 10%1 study (1/-)91.7 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 1.51 [0.91, 2.51]< 10%4 studies (4/-)5.6 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 1.60 [0.36, 7.08]< 10%4 studies (4/-)26.7 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 0.80 [0.09, 6.69]< 153%4 studies (4/-)58.3 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.05 [0.00, 0.92]< 10%1 study (1/-)97.7 %NAnot evaluable non important-
Pancytopenia TRAE (grade 3-4) 0.16 [0.01, 3.29]< 10%1 study (1/-)87.9 %NAnot evaluable non important-
Paraesthesia TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Peripheral oedema TRAE (grade 3-4) 1.22 [0.02, 61.84]< 10%1 study (1/-)46.1 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 2.43 [0.53, 11.19]< 10%3 studies (3/-)12.9 %lownot evaluable highnon important-
Pruritic rash TRAE (grade 3-4) 1.00 [0.06, 15.97]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 2.74 [0.76, 9.84]< 10%4 studies (4/-)6.2 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 1.17 [0.34, 3.98]< 10%4 studies (4/-)40.4 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 1.29 [0.31, 5.36]< 159%4 studies (4/-)36.2 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 0.05 [0.00, 0.82]< 10%1 study (1/-)98.1 %NAnot evaluable non important-
Thyroiditis TRAE (grade 3-4) 1.48 [0.11, 19.35]< 10%2 studies (2/-)38.3 %lownot evaluable highnon important-
Vitiligo TRAE (grade 3-4) 1.00 [0.13, 7.74]< 10%3 studies (3/-)50.1 %lownot evaluable highnon important-
Vomiting TRAE (grade 3-4) 1.29 [0.36, 4.65]< 124%4 studies (4/-)34.7 %lownot evaluable highnon important-
Weight decreased TRAE (grade 3-4) 0.67 [0.05, 8.74]< 10%2 studies (2/-)61.9 %lownot evaluable highnon important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 0.98 [0.14, 7.03]< 10%1 study (1/-)50.7 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 1.74 [0.50, 6.04]< 10%1 study (1/-)19.1 %NAnot evaluable non important-
Arthralgia AE (grade 3-4) 0.98 [0.02, 49.71]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 1.74 [0.50, 6.04]< 10%1 study (1/-)19.1 %NAnot evaluable non important-
Constipation AE (grade 3-4) 0.98 [0.02, 49.71]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 1.97 [0.07, 58.97]< 10%1 study (1/-)35.0 %NAnot evaluable non important-
Dermatitis acneiform AE (grade 3-4) 22.68 [1.32, 388.47]< 10%1 study (1/-)1.7 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 4.44 [1.47, 13.42]< 10%1 study (1/-)0.4 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 1.65 [0.39, 7.00]< 10%1 study (1/-)24.9 %NAnot evaluable non important-
Headache AE (grade 3-4) 1.97 [0.07, 58.97]< 10%1 study (1/-)35.0 %NAnot evaluable non important-
Hypertension AE (grade 3-4) 1.77 [0.73, 4.30]< 10%1 study (1/-)10.5 %NAnot evaluable non important-
Hypothyroidism AE (grade 3-4) 1.22 [0.02, 61.84]< 10%1 study (1/-)46.1 %NAnot evaluable non important-
Increase AST AE (grade 3-4) 3.00 [0.60, 15.03]< 10%1 study (1/-)9.1 %NAnot evaluable non important-
Increased ALT AE (grade 3-4) 1.99 [0.49, 8.06]< 10%1 study (1/-)16.8 %NAnot evaluable non important-
Increased Lipase Level AE (grade 3-4) 2.00 [0.59, 6.74]< 10%1 study (1/-)13.2 %NAnot evaluable non important-
Nausea AE (grade 3-4) 10.02 [0.54, 184.60]< 10%1 study (1/-)6.3 %NAnot evaluable non important-
Peripheral oedema AE (grade 3-4) 0.98 [0.06, 15.80]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 0.98 [0.02, 49.71]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 6.03 [0.72, 50.50]< 10%1 study (1/-)5.0 %NAnot evaluable non important-
Rash AE (grade 3-4) 7.83 [1.77, 34.66]< 10%1 study (1/-)0.3 %NAnot evaluable non important-
Rash maculopapular AE (grade 3-4) 7.98 [0.42, 151.89]< 10%1 study (1/-)8.6 %NAnot evaluable non important-
Sepsis AE (grade 3-4) 12.08 [0.67, 217.70]< 10%1 study (1/-)4.7 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 2.49 [0.48, 12.97]< 10%1 study (1/-)14.0 %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.