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head and neck cancer squamous cell cancer (HNSCC), 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) 0.87 [0.77, 0.99]< 153%7 studies (7/-)98.5 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.72 [0.64, 0.81]< 10%3 studies (3/-)100.0 %some concernnot evaluable moderateimportant-
PFS (extension) 0.87 [0.68, 1.11]< 10%1 study (1/-)86.7 %NAnot evaluable important-
progression or deaths (PFS) 1.05 [0.94, 1.18]< 157%7 studies (7/-)19.4 %some concernnot evaluable moderateimportant-
DCR 1.06 [0.77, 1.46]> 10%2 studies (2/-)64.0 %some concernnot evaluable moderatenon important-
objective responses (ORR) 0.99 [0.67, 1.47]> 181%7 studies (7/-)48.7 %some concernnot evaluable moderatenon important-
objective responses (ORR) (extension) 2.51 [1.07, 5.86]> 10%1 study (1/-)98.3 %NAnot evaluable non important-

safety endpoints 00

AE (any grade) 0.44 [0.27, 0.71]< 141%4 studies (4/-)100.0 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 1.15 [0.90, 1.47]< 139%4 studies (4/-)12.6 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.08 [0.80, 1.45]< 10%4 studies (4/-)30.9 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 0.90 [0.46, 1.78]< 188%4 studies (4/-)61.6 %some concernnot evaluable moderatenon important-
SAE (any grade) 1.30 [0.98, 1.72]< 10%2 studies (2/-)3.6 %some concernnot evaluable moderatenon important-
STRAE (any grade) 1.19 [0.89, 1.59]< 10%2 studies (2/-)12.2 %lownot evaluable highnon important-
TRAE (any grade) 0.29 [0.17, 0.48]< 182%7 studies (7/-)100.0 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 0.44 [0.18, 1.07]< 196%6 studies (6/-)96.5 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.24 [0.66, 2.32]< 11%7 studies (7/-)25.0 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 0.86 [0.55, 1.32]< 10%4 studies (4/-)75.9 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (grade 3-4) 1.28 [0.53, 3.10]< 10%1 study (1/-)29.1 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.49 [0.02, 14.76]< 10%1 study (1/-)65.6 %NAnot evaluable non important-
Acute kidney injury TRAE (grade 3-4) 1.14 [0.48, 2.75]< 10%3 studies (3/-)38.2 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 0.97 [0.20, 4.83]< 10%5 studies (5/-)51.4 %some concernnot evaluable moderatenon important-
Alopecia TRAE (grade 3-4) 0.98 [0.10, 9.44]< 10%3 studies (3/-)50.7 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 0.30 [0.12, 0.73]< 184%7 studies (7/-)99.6 %some concernserious moderatenon important-
Arthralgia TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 0.84 [0.41, 1.72]< 128%7 studies (7/-)68.6 %some concernserious moderatenon important-
Blood and lymphatic system disorders TRAE (grade 3-4) 0.12 [0.01, 2.59]< 197%3 studies (3/-)91.0 %some concernnot evaluable moderatenon important-
Blood creatinine increased TRAE (grade 3-4) 1.37 [0.50, 3.80]< 10%4 studies (4/-)27.2 %lownot evaluable highnon important-
Cardiac disorders TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Chills TRAE (grade 3-4) 1.45 [0.11, 18.87]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Colitis TRAE (grade 3-4) 0.77 [0.24, 2.43]< 10%5 studies (5/-)67.4 %some concernnot evaluable moderatenon important-
Constipation TRAE (grade 3-4) 0.98 [0.16, 6.04]< 10%4 studies (4/-)50.8 %some concernnot evaluable moderatenon important-
Cough TRAE (grade 3-4) 1.45 [0.11, 18.87]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 0.93 [0.45, 1.90]< 133%6 studies (6/-)58.2 %some concernnot evaluable moderatenon important-
Dermatitis acneiform TRAE (grade 3-4) 0.99 [0.06, 15.94]< 10%2 studies (2/-)50.2 %some concernnot evaluable moderatenon important-
Diarrhoea TRAE (grade 3-4) 0.60 [0.28, 1.29]< 10%7 studies (7/-)90.5 %some concernnot evaluable moderatenon important-
Dysgeusia TRAE (grade 3-4) 0.25 [0.01, 5.48]< 10%1 study (1/-)80.9 %NAnot evaluable non important-
Dyspepsia TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Dysphonia TRAE (grade 3-4) 0.99 [0.02, 49.96]< 10%1 study (1/-)50.2 %NAnot evaluable non important-
Dyspnoea TRAE (grade 3-4) 3.83 [0.17, 85.33]< 10%1 study (1/-)20.1 %NAnot evaluable non important-
Eczema TRAE (grade 3-4) 0.47 [0.01, 23.80]< 10%1 study (1/-)64.4 %NAnot evaluable non important-
Endocrine disorders TRAE (grade 3-4) 2.30 [0.45, 11.90]< 10%4 studies (4/-)16.1 %some concernnot evaluable moderatenon important-
Epistaxis TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Erythema TRAE (grade 3-4) 0.23 [0.01, 7.01]< 10%1 study (1/-)79.5 %NAnot evaluable non important-
Eye disorders TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 1.09 [0.65, 1.83]< 120%7 studies (7/-)37.0 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 0.26 [0.02, 3.80]< 170%2 studies (2/-)83.6 %lownot evaluable highnon important-
Gastritis TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Gastrointestinal disorders TRAE (grade 3-4) 0.18 [0.06, 0.57]< 156%3 studies (3/-)99.8 %some concernnot evaluable moderatenon important-
General disorders and administration site conditions TRAE (grade 3-4) 0.61 [0.15, 2.52]< 190%3 studies (3/-)75.2 %some concernnot evaluable moderatenon important-
Guillain-Barré syndrome TRAE (grade 3-4) 1.91 [0.06, 57.09]< 10%1 study (1/-)35.7 %NAnot evaluable non important-
Headache TRAE (grade 3-4) 0.97 [0.09, 10.72]< 10%2 studies (2/-)51.0 %lownot evaluable highnon important-
Hepatitis TRAE (grade 3-4) 2.59 [0.39, 17.34]< 10%3 studies (3/-)16.4 %some concernnot evaluable moderatenon important-
Hepatobiliary disorders TRAE (grade 3-4) 0.94 [0.15, 5.84]< 10%2 studies (2/-)52.4 %some concernnot evaluable moderatenon important-
Hypersensitivity TRAE (grade 3-4) 0.43 [0.03, 5.58]< 10%2 studies (2/-)74.0 %some concernnot evaluable moderatenon important-
Hypertension TRAE (grade 3-4) 1.77 [0.37, 8.44]< 10%2 studies (2/-)23.8 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 1.32 [0.30, 5.80]< 10%5 studies (5/-)35.9 %some concernnot evaluable moderatenon important-
Hypophysitis TRAE (grade 3-4) 1.55 [0.22, 11.07]< 10%3 studies (3/-)33.0 %some concernnot evaluable moderatenon important-
Hypothyroidism TRAE (grade 3-4) 1.02 [0.21, 4.85]< 10%6 studies (6/-)49.1 %some concernserious moderatenon important-
Increase AST TRAE (grade 3-4) 0.70 [0.15, 3.20]< 10%3 studies (3/-)67.8 %some concernnot evaluable moderatenon important-
Increased ALT TRAE (grade 3-4) 1.00 [0.25, 4.06]< 123%5 studies (5/-)49.9 %some concernserious moderatenon important-
Increased lipase level TRAE (grade 3-4) 4.55 [0.80, 25.88]< 10%2 studies (2/-)4.4 %lownot evaluable highnon important-
Infusion-related reactions TRAE (grade 3-4) 0.46 [0.18, 1.19]< 10%5 studies (5/-)94.4 %some concernnot evaluable moderatenon important-
Leucopenia TRAE (grade 3-4) 0.27 [0.10, 0.73]< 157%7 studies (7/-)99.5 %some concernserious moderatenon important-
Maculopapular rash TRAE (grade 3-4) 0.47 [0.04, 6.17]< 10%2 studies (2/-)71.5 %some concernnot evaluable moderatenon important-
Metabolism and nutrition disorders TRAE (grade 3-4) 0.47 [0.19, 1.17]< 179%3 studies (3/-)94.8 %some concernnot evaluable moderatenon important-
Mucosal inflammation TRAE (grade 3-4) 0.70 [0.30, 1.63]< 164%6 studies (6/-)79.8 %some concernnot evaluable moderatenon important-
Musculoskeletal and connective tissue disorders TRAE (grade 3-4) 1.91 [0.06, 57.09]< 10%1 study (1/-)35.7 %NAnot evaluable non important-
Myalgia TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Myocarditis TRAE (grade 3-4) 1.49 [0.11, 19.48]< 10%2 studies (2/-)38.1 %some concernnot evaluable moderatenon important-
Myositis TRAE (grade 3-4) 0.50 [0.05, 5.51]< 10%2 studies (2/-)71.4 %some concernnot evaluable moderatenon important-
Nausea TRAE (grade 3-4) 0.86 [0.44, 1.70]< 123%7 studies (7/-)66.4 %some concernnot evaluable moderatenon important-
Nephritis TRAE (grade 3-4) 2.20 [0.30, 15.93]< 10%3 studies (3/-)21.8 %some concernnot evaluable moderatenon important-
Nervous system disorders TRAE (grade 3-4) 0.47 [0.04, 5.26]< 10%1 study (1/-)72.7 %NAnot evaluable non important-
Neutropenia TRAE (grade 3-4) 0.21 [0.07, 0.60]< 184%6 studies (6/-)99.8 %some concernserious moderatenon important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.43 [0.03, 5.58]< 10%2 studies (2/-)74.0 %some concernnot evaluable moderatenon important-
Pancreatitis TRAE (grade 3-4) 1.49 [0.11, 19.48]< 10%2 studies (2/-)38.1 %some concernnot evaluable moderatenon important-
Pancytopenia TRAE (grade 3-4) 0.49 [0.04, 5.79]< 117%2 studies (2/-)71.3 %some concernnot evaluable moderatenon important-
Paraesthesia TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 0.34 [0.07, 1.72]< 10%3 studies (3/-)90.3 %some concernnot evaluable moderatenon important-
Peripheral oedema TRAE (grade 3-4) 0.97 [0.09, 10.72]< 10%2 studies (2/-)51.0 %lownot evaluable highnon important-
Pneumonia TRAE (grade 3-4) 0.76 [0.28, 2.08]< 10%1 study (1/-)70.1 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 2.98 [1.13, 7.85]< 10%5 studies (5/-)1.4 %some concernnot evaluable moderatenon important-
Pruritic rash TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Pruritus generalised TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 0.51 [0.08, 3.20]< 10%4 studies (4/-)76.2 %some concernnot evaluable moderatenon important-
Pyrexia TRAE (grade 3-4) 0.36 [0.06, 1.99]< 10%3 studies (3/-)87.8 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 0.25 [0.08, 0.81]< 122%6 studies (6/-)98.9 %some concernserious moderatenon important-
Renal and urinary disorders TRAE (grade 3-4) 1.05 [0.08, 13.66]< 10%2 studies (2/-)48.7 %some concernnot evaluable moderatenon important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 1.50 [0.46, 4.88]< 10%2 studies (2/-)25.3 %some concernnot evaluable moderatenon important-
Sepsis TRAE (grade 3-4) 0.37 [0.06, 2.50]< 10%2 studies (2/-)84.4 %lownot evaluable highnon important-
Severe skin reaction TRAE (grade 3-4) 0.27 [0.12, 0.61]< 130%3 studies (3/-)99.9 %some concernnot evaluable moderatenon important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 0.17 [0.07, 0.39]< 10%3 studies (3/-)100.0 %some concernnot evaluable moderatenon important-
Skin exfoliation TRAE (grade 3-4) 0.67 [0.04, 10.72]< 10%2 studies (2/-)61.1 %some concernnot evaluable moderatenon important-
Stevens-Johnson syndrome TRAE (grade 3-4) 0.95 [0.02, 48.13]< 10%1 study (1/-)51.0 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 0.68 [0.23, 2.00]< 167%6 studies (6/-)75.9 %some concernnot evaluable moderatenon important-
Thrombocytopenia TRAE (grade 3-4) 0.63 [0.14, 2.72]< 183%7 studies (7/-)73.3 %some concernnot evaluable moderatenon important-
Thyroiditis TRAE (grade 3-4) 0.78 [0.08, 7.48]< 10%3 studies (3/-)58.6 %some concernnot evaluable moderatenon important-
Urticaria TRAE (grade 3-4) 1.07 [0.08, 13.96]< 10%2 studies (2/-)48.0 %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.