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metastatic/advanced mGC or mGEJC, immune chekpoint inhibitors , 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) 0.88 [0.78, 0.99]< 160%8 studies (8/-)98.4 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.62 [0.51, 0.76]< 10%1 study (1/-)100.0 %NAnot evaluable important-
PFS (extension) 0.60 [0.48, 0.74]< 10%1 study (1/-)100.0 %NAnot evaluable important-
progression or deaths (PFS) 1.13 [0.85, 1.49]< 194%8 studies (8/-)19.6 %some concernnot evaluable moderateimportant-
DCR 0.77 [0.31, 1.90]> 192%3 studies (3/-)28.6 %some concernnot evaluable moderatenon important-
irORR 0.24 [0.03, 2.19]> 10%1 study (1/-)10.3 %NAnot evaluable non important-
irPFS 1.44 [1.09, 1.91]< 10%1 study (1/-)0.5 %NAnot evaluable non important-
objective responses (ORR) 0.98 [0.54, 1.76]> 190%7 studies (7/-)47.2 %some concernnot evaluable moderatenon important-

safety endpoints 00

AE (any grade) 1.01 [0.51, 2.00]< 163%4 studies (4/-)49.2 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 0.58 [0.18, 1.81]< 197%4 studies (4/-)82.6 %lownot evaluable highnon important-
AE leading to death (grade 5) 0.86 [0.57, 1.30]< 10%4 studies (4/-)75.8 %lownot evaluable highnon important-
AE leading to treatment discontinuation (any grade) 0.61 [0.24, 1.56]< 192%4 studies (4/-)85.0 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (grade 3-4) 0.69 [0.29, 1.66]< 10%1 study (1/-)79.5 %NAnot evaluable non important-
SAE (any grade) 0.97 [0.59, 1.60]< 171%2 studies (2/-)54.1 %some concernnot evaluable moderatenon important-
SAE (grade 3-4) 0.92 [0.61, 1.40]< 10%1 study (1/-)64.6 %NAnot evaluable non important-
STRAE (any grade) 1.52 [0.84, 2.76]< 171%3 studies (3/-)8.5 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 1.85 [1.39, 2.48]< 10%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-
TRAE (any grade) 0.67 [0.30, 1.51]< 196%8 studies (8/-)83.2 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 0.77 [0.30, 2.00]< 196%6 studies (6/-)70.2 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.72 [0.76, 3.90]< 10%6 studies (6/-)9.8 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 0.77 [0.31, 1.89]< 189%6 studies (6/-)71.7 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (grade 3-4) 1.49 [0.51, 4.32]< 156%2 studies (2/-)23.4 %some concernnot evaluable moderatenon important-

TRAE (grade 3-4) endpoints 00

Alopecia TRAE (grade 3-4) 0.50 [0.08, 3.03]< 10%4 studies (4/-)77.5 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 0.46 [0.15, 1.40]< 189%5 studies (5/-)91.4 %some concernnot evaluable moderatenon important-
Asthenia TRAE (grade 3-4) 0.54 [0.25, 1.15]< 124%5 studies (5/-)94.5 %some concernnot evaluable moderatenon important-
Blood creatinine increased TRAE (grade 3-4) 0.73 [0.09, 6.29]< 10%2 studies (2/-)61.1 %some concernnot evaluable moderatenon important-
Colitis TRAE (grade 3-4) 0.90 [0.12, 6.89]< 121%3 studies (3/-)54.1 %some concernnot evaluable moderatenon important-
Constipation TRAE (grade 3-4) 0.97 [0.06, 15.52]< 10%2 studies (2/-)50.9 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 0.64 [0.30, 1.35]< 141%7 studies (7/-)87.9 %some concernnot evaluable moderatenon important-
Diabetes TRAE (grade 3-4) 0.94 [0.02, 47.47]< 10%1 study (1/-)51.2 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 0.77 [0.35, 1.73]< 156%7 studies (7/-)73.4 %some concernnot evaluable moderatenon important-
Dizziness TRAE (grade 3-4) 0.73 [0.09, 6.31]< 10%2 studies (2/-)61.0 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 0.97 [0.06, 15.52]< 10%2 studies (2/-)50.9 %some concernnot evaluable moderatenon important-
Dysgeusia TRAE (grade 3-4) 0.97 [0.06, 15.52]< 10%2 studies (2/-)50.9 %some concernnot evaluable moderatenon important-
Endocrine disorders TRAE (grade 3-4) 4.01 [0.37, 43.00]< 12%2 studies (2/-)12.7 %some concernnot evaluable moderatenon important-
Fatigue TRAE (grade 3-4) 0.78 [0.37, 1.63]< 159%7 studies (7/-)74.5 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 0.08 [0.00, 1.40]< 10%1 study (1/-)95.7 %NAnot evaluable non important-
Gastrointestinal disorders TRAE (grade 3-4) 1.73 [1.04, 2.86]< 10%1 study (1/-)1.7 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 7.60 [0.40, 144.43]< 10%1 study (1/-)9.1 %NAnot evaluable non important-
Hepatobiliary disorders TRAE (grade 3-4) 1.81 [0.97, 3.36]< 10%1 study (1/-)3.0 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 0.68 [0.04, 10.84]< 10%2 studies (2/-)60.8 %some concernnot evaluable moderatenon important-
Hypophysitis TRAE (grade 3-4) 3.77 [0.17, 84.06]< 10%1 study (1/-)20.4 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 4.88 [1.25, 19.13]< 17%5 studies (5/-)1.2 %some concernserious moderatenon important-
Increase AST TRAE (grade 3-4) 1.95 [0.85, 4.47]< 10%3 studies (3/-)5.8 %some concernnot evaluable moderatenon important-
Increased ALT TRAE (grade 3-4) 0.97 [0.40, 2.40]< 10%3 studies (3/-)52.3 %some concernnot evaluable moderatenon important-
Increased lipase level TRAE (grade 3-4) 1.74 [0.36, 8.39]< 150%2 studies (2/-)24.5 %some concernnot evaluable moderatenon important-
Infusion-related reactions TRAE (grade 3-4) 0.95 [0.09, 10.52]< 10%2 studies (2/-)51.6 %some concernnot evaluable moderatenon important-
Leucopenia TRAE (grade 3-4) 2.43 [0.23, 25.98]< 134%2 studies (2/-)23.2 %lownot evaluable highnon important-
Maculopapular rash TRAE (grade 3-4) 0.49 [0.01, 24.66]< 10%1 study (1/-)63.8 %NAnot evaluable non important-
Mucosal inflammation TRAE (grade 3-4) 0.20 [0.01, 4.07]< 177%2 studies (2/-)85.1 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 0.79 [0.02, 40.48]< 10%1 study (1/-)54.6 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 0.65 [0.32, 1.32]< 135%7 studies (7/-)88.2 %some concernnot evaluable moderatenon important-
Neutropenia TRAE (grade 3-4) 0.25 [0.08, 0.74]< 188%5 studies (5/-)99.4 %some concernserious moderatenon important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.87 [0.28, 2.71]< 154%4 studies (4/-)59.8 %some concernnot evaluable moderatenon important-
Pancreatitis TRAE (grade 3-4) 0.47 [0.02, 14.02]< 10%1 study (1/-)66.7 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 1.28 [0.74, 2.22]< 12%5 studies (5/-)19.0 %some concernnot evaluable moderatenon important-
Peripheral sensory neuropathy TRAE (grade 3-4) 1.33 [0.50, 3.53]< 110%2 studies (2/-)28.5 %some concernnot evaluable moderatenon important-
Pneumonitis TRAE (grade 3-4) 2.04 [0.21, 20.20]< 10%2 studies (2/-)27.2 %some concernnot evaluable moderatenon important-
Pruritus TRAE (grade 3-4) 0.77 [0.11, 5.52]< 10%4 studies (4/-)60.0 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 0.98 [0.03, 29.24]< 10%1 study (1/-)50.6 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 0.98 [0.15, 6.45]< 10%4 studies (4/-)51.0 %lownot evaluable highnon important-
Renal and urinary disorders TRAE (grade 3-4) 5.92 [0.71, 49.31]< 10%1 study (1/-)5.1 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 13.96 [1.83, 106.45]< 10%1 study (1/-)0.6 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 1.88 [0.06, 56.28]< 10%1 study (1/-)36.0 %NAnot evaluable non important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 4.36 [1.79, 10.66]< 10%1 study (1/-)0.1 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 0.34 [0.02, 6.97]< 177%2 studies (2/-)75.7 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 1.00 [0.38, 2.62]< 146%3 studies (3/-)50.3 %some concernnot evaluable moderatenon important-
Thyroiditis TRAE (grade 3-4) 0.49 [0.01, 24.66]< 10%1 study (1/-)63.8 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.61 [0.32, 1.17]< 122%5 studies (5/-)93.2 %some concernnot evaluable moderatenon important-
Weight decreased TRAE (grade 3-4) 0.44 [0.06, 3.49]< 136%3 studies (3/-)77.9 %some concernnot evaluable moderatenon important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 1.14 [0.43, 3.04]< 10%1 study (1/-)39.3 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 0.97 [0.54, 1.75]< 10%1 study (1/-)53.7 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 2.48 [0.54, 11.47]< 10%1 study (1/-)12.3 %NAnot evaluable non important-
Back pain AE (grade 3-4) 0.73 [0.12, 4.41]< 10%1 study (1/-)63.4 %NAnot evaluable non important-
Constipation AE (grade 3-4) 0.98 [0.03, 29.24]< 10%1 study (1/-)50.6 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 0.54 [0.20, 1.42]< 10%1 study (1/-)89.5 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 1.96 [0.22, 17.71]< 10%1 study (1/-)27.5 %NAnot evaluable non important-
Dyspepsia AE (grade 3-4) 0.49 [0.01, 24.66]< 10%1 study (1/-)63.8 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 1.96 [0.09, 43.66]< 10%1 study (1/-)33.8 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 0.29 [0.07, 1.21]< 10%1 study (1/-)95.5 %NAnot evaluable non important-
Increase AST AE (grade 3-4) 1.48 [0.47, 4.67]< 10%1 study (1/-)25.2 %NAnot evaluable non important-
Increased ALT AE (grade 3-4) 1.31 [0.34, 5.00]< 10%1 study (1/-)34.7 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.24 [0.02, 2.68]< 10%1 study (1/-)87.4 %NAnot evaluable non important-
Peripheral oedema AE (grade 3-4) 0.98 [0.03, 29.24]< 10%1 study (1/-)50.6 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 0.49 [0.01, 24.66]< 10%1 study (1/-)63.8 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 1.47 [0.15, 14.22]< 10%1 study (1/-)37.1 %NAnot evaluable non important-
Rash AE (grade 3-4) 0.49 [0.01, 24.66]< 10%1 study (1/-)63.8 %NAnot evaluable non important-
Vomiting AE (grade 3-4) 0.65 [0.14, 2.92]< 10%1 study (1/-)71.4 %NAnot evaluable non important-
Weight decreased AE (grade 3-4) 0.98 [0.03, 29.24]< 10%1 study (1/-)50.6 %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.