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mML - 1st line (L1), 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) 0.66 [0.55, 0.81]< 173%9 studies (9/-)100.0 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.60 [0.47, 0.76]< 180%4 studies (4/-)100.0 %lownot evaluable highimportant-
PFS (extension) 0.50 [0.38, 0.65]< 185%5 studies (5/-)100.0 %lownot evaluable highimportant-
progression or deaths (PFS) 0.58 [0.45, 0.75]< 187%8 studies (8/-)100.0 %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) 2.71 [1.55, 4.72]> 193%9 studies (9/-)100.0 %lowserious highnon important-
objective responses (ORR) (extension) 5.31 [3.93, 7.17]> 155%5 studies (5/-)100.0 %lownot evaluable highnon important-

safety endpoints 00

AE (any grade) 2.55 [0.68, 9.53]< 184%3 studies (3/-)8.3 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 1.84 [0.81, 4.18]< 193%3 studies (3/-)7.3 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.50 [0.89, 2.52]< 10%4 studies (4/-)6.3 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 1.37 [0.38, 5.00]< 184%3 studies (3/-)31.7 %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) 1.53 [0.36, 6.48]< 196%2 studies (2/-)28.1 %some concernnot evaluable moderatenon 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) 1.55 [0.83, 2.88]< 178%6 studies (6/-)8.2 %lownot evaluable highnon important-
TRAE (grade 3-4) 1.87 [0.89, 3.92]< 195%6 studies (6/-)5.0 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 2.84 [0.61, 13.25]< 10%4 studies (4/-)9.3 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 2.73 [1.08, 6.91]< 193%4 studies (4/-)1.7 %lownot evaluable highnon important-
TRAE leading to discontinuation (grade 3-4) 2.30 [0.82, 6.41]< 193%4 studies (4/-)5.6 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.53 [0.13, 2.13]< 10%5 studies (5/-)81.5 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 2.30 [0.79, 6.68]< 115%5 studies (5/-)6.3 %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) 1.55 [0.65, 3.71]< 10%6 studies (6/-)16.3 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 0.96 [0.35, 2.65]< 10%6 studies (6/-)53.1 %lowserious 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-
Chills TRAE (grade 3-4) 0.49 [0.01, 24.92]< 10%1 study (1/-)63.7 %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) 1.35 [0.29, 6.37]< 189%4 studies (4/-)35.3 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 0.99 [0.08, 12.95]< 10%2 studies (2/-)50.4 %lownot evaluable highnon important-
Cough TRAE (grade 3-4) 1.00 [0.18, 5.57]< 10%4 studies (4/-)50.2 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 1.59 [0.46, 5.54]< 10%6 studies (6/-)23.4 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 1.18 [0.59, 2.36]< 167%6 studies (6/-)31.6 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 1.42 [0.69, 2.95]< 10%5 studies (5/-)17.1 %lownot evaluable highnon important-
Dyspnoea TRAE (grade 3-4) 3.27 [0.80, 13.40]< 10%4 studies (4/-)5.0 %lownot evaluable highnon important-
Endocrine disorders TRAE (grade 3-4) 1.24 [0.23, 6.63]< 10%1 study (1/-)40.3 %NAnot evaluable non important-
Erythema TRAE (grade 3-4) 7.41 [0.37, 148.78]< 10%1 study (1/-)9.8 %NAnot evaluable non important-
Eye disorders TRAE (grade 3-4) 0.98 [0.02, 49.62]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 2.84 [1.39, 5.84]< 14%6 studies (6/-)0.2 %lownot evaluable highnon important-
Gastrointestinal disorders TRAE (grade 3-4) 2.22 [0.77, 6.34]< 10%1 study (1/-)6.9 %NAnot evaluable non important-
Headache TRAE (grade 3-4) 1.67 [0.42, 6.59]< 10%5 studies (5/-)23.2 %lownot evaluable highnon important-
Hepatitis TRAE (grade 3-4) 4.81 [1.19, 19.40]< 10%5 studies (5/-)1.4 %lowserious highnon important-
Hepatobiliary disorders TRAE (grade 3-4) 15.93 [0.93, 273.74]< 10%1 study (1/-)3.0 %NAnot evaluable non 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) 2.90 [0.75, 11.29]< 10%6 studies (6/-)6.2 %lowserious highnon important-
Hypophysitis TRAE (grade 3-4) 0.84 [0.27, 2.68]< 138%4 studies (4/-)61.2 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 1.22 [0.23, 6.34]< 10%5 studies (5/-)40.8 %lowserious highnon important-
Increase AST TRAE (grade 3-4) 4.87 [2.20, 10.77]< 14%5 studies (5/-)0.0 %lownot evaluable highnon important-
Increased ALT TRAE (grade 3-4) 3.64 [1.41, 9.42]< 152%5 studies (5/-)0.4 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 1.80 [1.02, 3.16]< 166%5 studies (5/-)2.1 %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) 1.65 [1.02, 2.69]< 10%6 studies (6/-)2.2 %lowserious highnon important-
Myalgia TRAE (grade 3-4) 1.46 [0.40, 5.27]< 10%6 studies (6/-)28.4 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 1.06 [0.25, 4.41]< 147%6 studies (6/-)47.1 %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-
Pancreatitis TRAE (grade 3-4) 5.93 [0.30, 118.96]< 10%1 study (1/-)12.5 %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) 2.10 [0.68, 6.47]< 10%5 studies (5/-)9.8 %lownot evaluable highnon important-
Pruritic rash TRAE (grade 3-4) 0.83 [0.12, 5.93]< 10%4 studies (4/-)57.2 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 3.01 [1.06, 8.55]< 10%6 studies (6/-)1.9 %lowserious highnon important-
Pyrexia TRAE (grade 3-4) 1.43 [0.51, 4.01]< 10%6 studies (6/-)24.6 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 1.56 [0.64, 3.79]< 146%6 studies (6/-)16.5 %lownot evaluable highnon important-
Renal and urinary disorders TRAE (grade 3-4) 0.98 [0.03, 29.71]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 1.48 [0.15, 14.67]< 10%1 study (1/-)36.9 %NAnot evaluable non important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 9.64 [0.55, 170.02]< 10%1 study (1/-)6.3 %NAnot evaluable non 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) 1.65 [0.21, 12.81]< 10%3 studies (3/-)31.7 %lownot evaluable highnon important-
Vitiligo TRAE (grade 3-4) 0.88 [0.17, 4.57]< 10%5 studies (5/-)56.1 %lownot evaluable highnon important-
Vomiting TRAE (grade 3-4) 1.75 [0.61, 5.02]< 119%6 studies (6/-)14.9 %lownot evaluable highnon important-
Weight decreased TRAE (grade 3-4) 0.60 [0.08, 4.66]< 10%3 studies (3/-)68.6 %lownot evaluable highnon important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 2.45 [0.65, 9.22]< 128%2 studies (2/-)9.3 %some concernnot evaluable moderatenon 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) 0.56 [0.04, 8.91]< 169%2 studies (2/-)65.8 %some concernnot evaluable moderatenon important-
Constipation AE (grade 3-4) 0.98 [0.17, 5.69]< 10%2 studies (2/-)50.8 %some concernnot evaluable moderatenon important-
Cough AE (grade 3-4) 1.97 [0.07, 58.81]< 10%1 study (1/-)35.0 %NAnot evaluable non important-
Decreased appetite AE (grade 3-4) 8.48 [1.48, 48.62]< 10%2 studies (2/-)0.8 %some concernnot evaluable moderatenon 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-
Dyspnoea AE (grade 3-4) 4.00 [0.84, 18.98]< 10%1 study (1/-)4.1 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 2.95 [1.30, 6.71]< 10%2 studies (2/-)0.5 %some concernnot evaluable moderatenon important-
Headache AE (grade 3-4) 1.97 [0.28, 14.03]< 10%2 studies (2/-)25.1 %some concernnot evaluable moderatenon 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) 2.23 [0.43, 11.65]< 139%2 studies (2/-)17.1 %some concernnot evaluable moderatenon important-
Neutropenia AE (grade 3-4) 0.03 [0.00, 0.19]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Peripheral oedema AE (grade 3-4) 2.70 [0.49, 14.83]< 10%2 studies (2/-)12.7 %some concernnot evaluable moderatenon 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.