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mML - 1st line (L1), 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) 0.54 [0.41, 0.69]< 161%4 studies (4/-)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) 0.53 [0.40, 0.70]< 180%4 studies (4/-)100.0 %lownot evaluable highimportant-
DOR (extension) 3.45 [1.46, 8.18]> 10%1 study (1/-)99.8 %NAnot evaluable non important-
objective responses (ORR) 3.07 [1.93, 4.90]> 178%4 studies (4/-)100.0 %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) 0.78 [0.34, 1.76]< 10%1 study (1/-)72.7 %NAnot evaluable non important-
AE (grade 3-4) 0.84 [0.56, 1.25]< 10%1 study (1/-)80.5 %NAnot evaluable non important-
AE leading to death (grade 5) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
AE leading to treatment discontinuation (any grade) 0.55 [0.28, 1.10]< 10%1 study (1/-)95.5 %NAnot evaluable non 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) 1.06 [0.54, 2.07]< 10%1 study (1/-)43.8 %NAnot evaluable non important-
STRAE (grade 3-4) 0.99 [0.44, 2.27]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
TRAE (any grade) 1.44 [0.69, 3.03]< 184%3 studies (3/-)16.5 %lownot evaluable highnon important-
TRAE (grade 3-4) 1.30 [0.32, 5.21]< 197%3 studies (3/-)35.8 %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) 1.74 [0.30, 10.07]< 10%3 studies (3/-)26.9 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 0.63 [0.13, 3.11]< 10%3 studies (3/-)71.6 %lownot evaluable highnon 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) 1.96 [0.28, 13.61]< 10%3 studies (3/-)24.8 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 1.42 [0.30, 6.65]< 183%3 studies (3/-)32.8 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 1.00 [0.10, 9.60]< 10%3 studies (3/-)50.1 %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-
Fatigue TRAE (grade 3-4) 1.55 [0.35, 6.83]< 150%3 studies (3/-)28.2 %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) 2.69 [0.38, 18.90]< 10%3 studies (3/-)16.2 %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) 1.80 [0.82, 3.94]< 158%2 studies (2/-)7.1 %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) 2.57 [0.74, 8.91]< 10%3 studies (3/-)6.9 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 1.23 [0.19, 8.14]< 10%3 studies (3/-)41.4 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 1.68 [0.13, 21.48]< 145%3 studies (3/-)34.6 %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-
Pneumonitis TRAE (grade 3-4) 1.93 [0.33, 11.21]< 10%2 studies (2/-)23.2 %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) 2.86 [0.63, 12.95]< 10%3 studies (3/-)8.7 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 1.09 [0.16, 7.27]< 10%3 studies (3/-)46.6 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 1.58 [0.11, 21.84]< 171%3 studies (3/-)36.8 %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) 2.49 [0.59, 10.47]< 10%3 studies (3/-)10.7 %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-

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.