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multiple myeloma, 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) 1.75 [1.10, 2.78]< 10%2 studies (2/-)0.9 %some concernnot evaluable moderatecrucial-
progression or deaths (PFS) 1.44 [1.05, 1.97]< 10%2 studies (2/-)1.3 %some concernnot evaluable moderateimportant-
DCR 0.88 [0.56, 1.39]> 10%2 studies (2/-)29.5 %some concernnot evaluable moderatenon important-
objective responses (ORR) 0.93 [0.65, 1.31]> 10%2 studies (2/-)33.0 %some concernnot evaluable moderatenon important-

safety endpoints 00

AE (any grade) 1.82 [0.66, 5.02]< 115%2 studies (2/-)12.5 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 1.97 [1.37, 2.81]< 10%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 2.53 [0.90, 7.11]< 144%2 studies (2/-)3.9 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 2.62 [1.45, 4.72]< 10%1 study (1/-)0.1 %NAnot evaluable non important-
SAE (any grade) 1.88 [1.33, 2.65]< 10%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 3.00 [0.60, 15.11]< 10%1 study (1/-)9.2 %NAnot evaluable non important-
TRAE leading to discontinuation (any grade) 2.91 [1.43, 5.93]< 10%1 study (1/-)0.2 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Adrenal insufficiency TRAE (grade 3-4) 1.95 [0.07, 58.66]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 1.95 [0.07, 58.66]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Diabetes TRAE (grade 3-4) 1.95 [0.07, 58.66]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Dry skin TRAE (grade 3-4) 1.95 [0.07, 58.66]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 1.99 [0.18, 22.07]< 10%2 studies (2/-)28.9 %some concernnot evaluable moderatenon important-
Hypersensitivity TRAE (grade 3-4) 0.97 [0.02, 49.37]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 3.09 [0.28, 33.55]< 10%2 studies (2/-)17.9 %some concernnot evaluable moderatenon important-
Hypothyroidism TRAE (grade 3-4) 0.99 [0.06, 15.92]< 10%2 studies (2/-)50.3 %some concernnot evaluable moderatenon important-
Infusion-related reactions TRAE (grade 3-4) 2.33 [0.20, 26.64]< 10%2 studies (2/-)25.0 %some concernnot evaluable moderatenon important-
Myocarditis TRAE (grade 3-4) 1.47 [0.11, 19.26]< 10%2 studies (2/-)38.5 %some concernnot evaluable moderatenon important-
Pancreatitis TRAE (grade 3-4) 1.95 [0.07, 58.66]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 1.48 [0.11, 19.36]< 10%2 studies (2/-)38.4 %some concernnot evaluable moderatenon important-
Pruritic rash TRAE (grade 3-4) 1.95 [0.07, 58.66]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 13.65 [1.74, 107.28]< 10%2 studies (2/-)0.7 %some concernnot evaluable moderatenon important-
Stevens-Johnson syndrome TRAE (grade 3-4) 1.47 [0.11, 19.26]< 10%2 studies (2/-)38.5 %some concernnot evaluable moderatenon important-
Thyroiditis TRAE (grade 3-4) 0.97 [0.02, 49.37]< 10%1 study (1/-)50.5 %NAnot evaluable non important-

AE (grade 3-4) endpoints 00

Anaemia AE (grade 3-4) 1.52 [0.87, 2.65]< 10%2 studies (2/-)7.0 %some concernnot evaluable moderatenon important-
Asthenia AE (grade 3-4) 0.16 [0.01, 3.32]< 10%1 study (1/-)87.8 %NAnot evaluable non important-
Back pain AE (grade 3-4) 0.54 [0.04, 8.08]< 165%2 studies (2/-)67.2 %some concernnot evaluable moderatenon important-
Constipation AE (grade 3-4) 2.91 [0.29, 28.87]< 10%2 studies (2/-)18.3 %some concernnot evaluable moderatenon important-
Cough AE (grade 3-4) 0.67 [0.05, 8.73]< 10%2 studies (2/-)62.0 %some concernnot evaluable moderatenon important-
Decreased appetite AE (grade 3-4) 0.64 [0.11, 3.91]< 10%1 study (1/-)68.3 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 2.45 [0.27, 21.97]< 139%2 studies (2/-)21.3 %some concernnot evaluable moderatenon important-
Dizziness AE (grade 3-4) 2.03 [0.07, 60.94]< 10%1 study (1/-)34.4 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 1.78 [0.05, 60.46]< 173%2 studies (2/-)37.6 %some concernnot evaluable moderatenon important-
Fatigue AE (grade 3-4) 0.34 [0.01, 11.05]< 179%2 studies (2/-)72.4 %some concernnot evaluable moderatenon important-
Headache AE (grade 3-4) 1.01 [0.02, 51.24]< 10%1 study (1/-)49.8 %NAnot evaluable non important-
Increased ALT AE (grade 3-4) 3.13 [0.62, 15.84]< 10%1 study (1/-)8.4 %NAnot evaluable non important-
Nausea AE (grade 3-4) 1.71 [0.26, 11.34]< 10%2 studies (2/-)29.0 %some concernnot evaluable moderatenon important-
Neutropenia AE (grade 3-4) 1.48 [0.83, 2.63]< 136%2 studies (2/-)9.3 %some concernnot evaluable moderatenon important-
Peripheral oedema AE (grade 3-4) 0.99 [0.09, 10.99]< 10%2 studies (2/-)50.3 %some concernnot evaluable moderatenon important-
Pneumonia AE (grade 3-4) 1.16 [0.62, 2.15]< 10%2 studies (2/-)32.3 %some concernnot evaluable moderatenon important-
Pyrexia AE (grade 3-4) 1.21 [0.04, 36.28]< 171%2 studies (2/-)45.6 %some concernnot evaluable moderatenon important-
Rash AE (grade 3-4) 6.04 [0.72, 50.82]< 10%1 study (1/-)5.0 %NAnot evaluable non important-
Thrombocytopenia AE (grade 3-4) 1.87 [0.75, 4.63]< 10%1 study (1/-)8.9 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 3.93 [0.18, 87.94]< 10%1 study (1/-)19.7 %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.