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mML - 1st line (L1), nivolumab plus ipilimumab , 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) 0.62 [0.53, 0.73]< 10%3 studies (3/-)100.0 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.66 [0.42, 1.04]< 189%2 studies (2/-)96.4 %lownot evaluable highimportant-
PFS (extension) 0.50 [0.31, 0.83]< 191%3 studies (3/-)99.7 %lownot evaluable highimportant-
progression or deaths (PFS) 0.51 [0.32, 0.80]< 183%3 studies (3/-)99.8 %lownot evaluable highimportant-
objective responses (ORR) 5.33 [1.47, 19.35]> 195%3 studies (3/-)99.4 %lownot evaluable highnon important-
objective responses (ORR) (extension) 6.41 [4.99, 8.23]> 10%3 studies (3/-)100.0 %lownot evaluable highnon important-

safety endpoints 00

TRAE (any grade) 2.72 [1.34, 5.52]< 156%3 studies (3/-)0.3 %lownot evaluable highnon important-
TRAE (grade 3-4) 4.24 [3.36, 5.33]< 10%3 studies (3/-)0.0 %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) 4.36 [3.35, 5.68]< 10%3 studies (3/-)0.0 %lownot evaluable highnon important-
TRAE leading to discontinuation (grade 3-4) 3.73 [2.37, 5.86]< 150%3 studies (3/-)0.0 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.59 [0.11, 3.22]< 10%3 studies (3/-)72.9 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 1.87 [0.34, 10.33]< 153%3 studies (3/-)23.8 %lownot evaluable highnon important-
Arthralgia TRAE (grade 3-4) 1.89 [0.34, 10.48]< 10%3 studies (3/-)23.3 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 0.63 [0.12, 3.30]< 10%3 studies (3/-)70.6 %lownot evaluable highnon important-
Chills TRAE (grade 3-4) 0.49 [0.01, 24.92]< 10%1 study (1/-)63.7 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 2.87 [0.75, 11.03]< 181%3 studies (3/-)6.3 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 0.98 [0.03, 29.71]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Cough TRAE (grade 3-4) 0.42 [0.04, 4.83]< 10%2 studies (2/-)75.4 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 3.48 [0.70, 17.36]< 10%3 studies (3/-)6.5 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 1.91 [1.01, 3.63]< 148%3 studies (3/-)2.4 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 1.00 [0.06, 15.97]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
Dyspnoea TRAE (grade 3-4) 3.62 [0.77, 17.10]< 10%3 studies (3/-)5.2 %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-
Fatigue TRAE (grade 3-4) 4.52 [1.92, 10.63]< 10%3 studies (3/-)0.0 %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) 2.41 [0.48, 12.22]< 10%3 studies (3/-)14.5 %lownot evaluable highnon important-
Hepatitis TRAE (grade 3-4) 6.87 [1.26, 37.62]< 10%3 studies (3/-)1.3 %lownot evaluable highnon important-
Hepatobiliary disorders TRAE (grade 3-4) 15.93 [0.93, 273.74]< 10%1 study (1/-)3.0 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 3.42 [0.53, 22.13]< 10%3 studies (3/-)9.9 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 1.19 [0.38, 3.72]< 124%3 studies (3/-)38.0 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 1.36 [0.18, 10.58]< 10%3 studies (3/-)38.5 %lownot evaluable highnon important-
Increase AST TRAE (grade 3-4) 7.83 [3.20, 19.16]< 10%3 studies (3/-)0.0 %lownot evaluable highnon important-
Increased ALT TRAE (grade 3-4) 6.62 [3.31, 13.26]< 10%3 studies (3/-)0.0 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 2.85 [1.81, 4.50]< 10%3 studies (3/-)0.0 %lownot evaluable highnon important-
Maculopapular rash TRAE (grade 3-4) 3.75 [1.15, 12.21]< 10%3 studies (3/-)1.4 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 1.05 [0.16, 6.91]< 10%3 studies (3/-)48.1 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 3.01 [0.62, 14.55]< 129%3 studies (3/-)8.6 %lownot evaluable highnon important-
Pneumonitis TRAE (grade 3-4) 2.14 [0.56, 8.15]< 10%3 studies (3/-)13.3 %lownot evaluable highnon important-
Pruritic rash TRAE (grade 3-4) 0.79 [0.08, 7.59]< 10%3 studies (3/-)58.2 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 4.52 [1.14, 17.86]< 10%3 studies (3/-)1.6 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 2.70 [0.54, 13.50]< 10%3 studies (3/-)11.4 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 3.05 [1.22, 7.65]< 11%3 studies (3/-)0.9 %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-
Thyroiditis TRAE (grade 3-4) 2.00 [0.18, 22.08]< 10%2 studies (2/-)28.8 %lownot evaluable highnon important-
Vitiligo TRAE (grade 3-4) 0.61 [0.07, 5.24]< 10%3 studies (3/-)67.3 %lownot evaluable highnon important-
Vomiting TRAE (grade 3-4) 5.19 [1.33, 20.26]< 10%3 studies (3/-)0.9 %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.