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lung cancer : non small cell (NSCLC), Immune checkpoint association , 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) 0.85 [0.74, 0.99]< 156%5 studies (5/-)98.4 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.66 [0.55, 0.80]< 10%1 study (1/-)100.0 %NAnot evaluable important-
PFS (extension) 0.68 [0.57, 0.82]< 10%1 study (1/-)100.0 %NAnot evaluable important-
progression or deaths (PFS) 0.81 [0.69, 0.96]< 164%6 studies (6/-)99.2 %some concernnot evaluable moderateimportant-
objective responses (ORR) 1.42 [1.05, 1.91]> 169%6 studies (6/-)98.9 %some concernnot evaluable moderatenon important-

safety endpoints 00

AE (any grade) 0.53 [0.30, 0.91]< 10%2 studies (2/-)98.9 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 0.88 [0.61, 1.27]< 144%2 studies (2/-)74.6 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.93 [1.14, 3.29]< 10%2 studies (2/-)0.8 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 1.33 [0.95, 1.84]< 10%2 studies (2/-)4.7 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (grade 3-4) 2.14 [1.32, 3.47]< 10%1 study (1/-)0.1 %NAnot evaluable non important-
SAE (any grade) 1.86 [1.31, 2.62]< 10%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-
STRAE (any grade) 1.90 [1.55, 2.32]< 10%4 studies (4/-)0.0 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 1.83 [1.47, 2.28]< 10%4 studies (4/-)0.0 %some concernnot evaluable moderatenon important-
TRAE (any grade) 0.68 [0.37, 1.26]< 189%5 studies (5/-)88.9 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 0.84 [0.57, 1.25]< 183%5 studies (5/-)80.4 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.22 [0.61, 2.45]< 10%4 studies (4/-)28.9 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 2.49 [1.73, 3.56]< 152%5 studies (5/-)0.0 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (grade 3-4) 3.56 [2.57, 4.94]< 10%4 studies (4/-)0.0 %some concernnot evaluable moderatenon important-

TRAE (grade 3-4) endpoints 00

Acute kidney injury TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 4.26 [0.71, 25.42]< 10%3 studies (3/-)5.7 %some concernnot evaluable moderatenon important-
Alopecia TRAE (grade 3-4) 0.95 [0.02, 47.95]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 0.18 [0.08, 0.42]< 159%5 studies (5/-)100.0 %some concernnot evaluable moderatenon important-
Asthenia TRAE (grade 3-4) 0.64 [0.26, 1.57]< 121%5 studies (5/-)83.4 %some concernnot evaluable moderatenon important-
Colitis TRAE (grade 3-4) 8.18 [1.51, 44.34]< 10%3 studies (3/-)0.8 %some concernnot evaluable moderatenon important-
Constipation TRAE (grade 3-4) 0.69 [0.11, 4.24]< 10%4 studies (4/-)65.6 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 0.81 [0.40, 1.64]< 10%5 studies (5/-)71.9 %some concernserious moderatenon important-
Diabetes TRAE (grade 3-4) 1.90 [0.06, 56.82]< 10%1 study (1/-)35.8 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 3.76 [1.78, 7.94]< 10%5 studies (5/-)0.0 %some concernnot evaluable moderatenon important-
Dyspnoea TRAE (grade 3-4) 2.56 [0.11, 57.33]< 10%1 study (1/-)27.9 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 1.18 [0.54, 2.58]< 134%5 studies (5/-)33.5 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 1.38 [0.60, 3.15]< 10%1 study (1/-)22.3 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 4.15 [0.64, 26.90]< 18%2 studies (2/-)6.8 %some concernnot evaluable moderatenon important-
Hypersensitivity TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Hypertension TRAE (grade 3-4) 1.27 [0.11, 14.23]< 10%1 study (1/-)42.2 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 1.19 [0.09, 15.52]< 10%2 studies (2/-)44.8 %some concernnot evaluable moderatenon important-
Hypophysitis TRAE (grade 3-4) 1.56 [0.14, 17.23]< 10%2 studies (2/-)36.0 %some concernnot evaluable moderatenon important-
Hypothyroidism TRAE (grade 3-4) 2.04 [0.36, 11.70]< 10%4 studies (4/-)21.3 %some concernnot evaluable moderatenon important-
Increase AST TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 1.73 [0.42, 7.13]< 10%2 studies (2/-)22.5 %some concernnot evaluable moderatenon important-
Increased lipase level TRAE (grade 3-4) 4.56 [0.64, 32.21]< 128%2 studies (2/-)6.5 %some concernnot evaluable moderatenon important-
Infusion-related reactions TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 0.10 [0.01, 2.08]< 10%1 study (1/-)92.8 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 4.93 [0.57, 42.41]< 10%1 study (1/-)7.4 %NAnot evaluable non important-
Myositis TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 0.61 [0.24, 1.55]< 116%5 studies (5/-)85.2 %some concernnot evaluable moderatenon important-
Nephritis TRAE (grade 3-4) 0.95 [0.02, 47.95]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Neutropenia TRAE (grade 3-4) 0.05 [0.00, 0.46]< 182%5 studies (5/-)99.5 %some concernserious moderatenon important-
Pancreatitis TRAE (grade 3-4) 2.56 [0.11, 57.33]< 10%1 study (1/-)27.9 %NAnot evaluable non important-
Peripheral oedema TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Pneumonia TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 7.30 [1.34, 39.79]< 10%2 studies (2/-)1.1 %some concernnot evaluable moderatenon important-
Pruritic rash TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 2.85 [0.64, 12.68]< 10%5 studies (5/-)8.5 %some concernserious moderatenon important-
Pyrexia TRAE (grade 3-4) 0.32 [0.01, 9.50]< 10%1 study (1/-)74.3 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 3.04 [0.61, 15.20]< 141%5 studies (5/-)8.9 %some concernserious moderatenon important-
Stomatitis TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 0.22 [0.02, 2.51]< 172%3 studies (3/-)88.8 %some concernnot evaluable moderatenon important-
Thyroiditis TRAE (grade 3-4) 0.63 [0.01, 32.23]< 10%1 study (1/-)58.8 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.28 [0.08, 0.98]< 142%5 studies (5/-)97.6 %some concernnot evaluable moderatenon important-
Weight decreased TRAE (grade 3-4) 1.27 [0.04, 38.28]< 10%1 study (1/-)44.5 %NAnot evaluable non important-

AE (grade 3-4) endpoints 00

Alopecia AE (grade 3-4) 0.95 [0.02, 47.95]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 0.36 [0.04, 3.34]< 191%2 studies (2/-)81.4 %some concernnot evaluable moderatenon important-
Arthralgia AE (grade 3-4) 2.01 [0.36, 11.05]< 10%1 study (1/-)21.3 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.70 [0.29, 1.72]< 17%2 studies (2/-)77.9 %some concernnot evaluable moderatenon important-
Back pain AE (grade 3-4) 0.58 [0.14, 2.44]< 10%2 studies (2/-)77.1 %some concernnot evaluable moderatenon important-
Constipation AE (grade 3-4) 1.29 [0.28, 5.92]< 10%2 studies (2/-)37.1 %lownot evaluable highnon important-
Cough AE (grade 3-4) 0.66 [0.05, 8.56]< 10%2 studies (2/-)62.5 %lownot evaluable highnon important-
Decreased appetite AE (grade 3-4) 1.78 [0.55, 5.75]< 10%2 studies (2/-)16.7 %some concernnot evaluable moderatenon important-
Diarrhoea AE (grade 3-4) 3.61 [0.84, 15.63]< 144%2 studies (2/-)4.3 %some concernnot evaluable moderatenon important-
Dyspnoea AE (grade 3-4) 0.97 [0.46, 2.06]< 10%2 studies (2/-)52.8 %lownot evaluable highnon important-
Fatigue AE (grade 3-4) 1.38 [0.65, 2.91]< 10%2 studies (2/-)20.1 %some concernnot evaluable moderatenon important-
Hypothyroidism AE (grade 3-4) 1.00 [0.06, 16.01]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Increase AST AE (grade 3-4) 2.52 [0.48, 13.09]< 10%1 study (1/-)13.7 %NAnot evaluable non important-
Increased ALT AE (grade 3-4) 2.28 [0.69, 7.50]< 10%1 study (1/-)8.7 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.90 [0.21, 3.82]< 115%2 studies (2/-)55.4 %some concernnot evaluable moderatenon important-
Neutropenia AE (grade 3-4) 0.01 [0.00, 0.19]< 10%1 study (1/-)99.9 %NAnot evaluable non important-
Pneumonia AE (grade 3-4) 1.36 [0.72, 2.56]< 10%1 study (1/-)17.2 %NAnot evaluable non important-
Pneumonitis AE (grade 3-4) 2.21 [0.83, 5.91]< 10%1 study (1/-)5.6 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 0.59 [0.08, 4.61]< 10%2 studies (2/-)69.1 %lownot evaluable highnon important-
Pyrexia AE (grade 3-4) 3.05 [0.28, 33.02]< 10%2 studies (2/-)18.1 %lownot evaluable highnon important-
Rash AE (grade 3-4) 3.86 [0.24, 62.86]< 149%2 studies (2/-)17.4 %some concernnot evaluable moderatenon important-
Thrombocytopenia AE (grade 3-4) 0.03 [0.00, 0.42]< 10%1 study (1/-)99.4 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 0.72 [0.03, 20.37]< 179%2 studies (2/-)57.5 %some concernnot evaluable moderatenon important-
Weight decreased AE (grade 3-4) 2.86 [0.30, 27.64]< 10%1 study (1/-)18.3 %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.