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metastatic/advanced OC (mOC) - 2nd line (L2), avelumab plus pegylated liposomal doxorubicin , 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) 0.89 [0.69, 1.15]< 10%1 study (1/-)81.2 %NAnot evaluable crucial-
progression or deaths (PFS) 0.78 [0.54, 1.13]< 10%1 study (1/-)90.5 %NAnot evaluable important-
DCR 2.79 [1.83, 4.24]> 10%1 study (1/-)100.0 %NAnot evaluable non important-
objective responses (ORR) 3.46 [1.39, 8.64]> 10%1 study (1/-)99.6 %NAnot evaluable non important-

safety endpoints 00

TRAE (grade 3-4) 1.66 [1.08, 2.57]< 10%1 study (1/-)1.1 %NAnot evaluable non important-
TRAE leading to death (grade 5) 0.48 [0.02, 14.54]< 10%1 study (1/-)65.9 %NAnot evaluable non important-
TRAE leading to discontinuation (any grade) 0.58 [0.23, 1.44]< 10%1 study (1/-)88.0 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.97 [0.06, 15.67]< 10%1 study (1/-)50.8 %NAnot evaluable non important-
Acute kidney injury TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 0.64 [0.22, 1.83]< 10%1 study (1/-)79.9 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 3.96 [0.44, 35.74]< 10%1 study (1/-)11.2 %NAnot evaluable non important-
Blood creatinine increased TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Constipation TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Decreased appetite TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Dry skin TRAE (grade 3-4) 0.48 [0.02, 14.54]< 10%1 study (1/-)65.9 %NAnot evaluable non important-
Dyspnoea TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 3.37 [0.91, 12.46]< 10%1 study (1/-)3.5 %NAnot evaluable non important-
Febrile neutropenia TRAE (grade 3-4) 0.32 [0.03, 3.11]< 10%1 study (1/-)83.5 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Hypersensitivity TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Hypertension TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Increase AST TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 3.92 [0.18, 87.59]< 10%1 study (1/-)19.7 %NAnot evaluable non important-
Increased lipase level TRAE (grade 3-4) 3.92 [0.18, 87.59]< 10%1 study (1/-)19.7 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 0.97 [0.06, 15.67]< 10%1 study (1/-)50.8 %NAnot evaluable non important-
Leucopenia TRAE (grade 3-4) 0.32 [0.03, 3.11]< 10%1 study (1/-)83.5 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 4.97 [0.57, 42.99]< 10%1 study (1/-)7.4 %NAnot evaluable non important-
Mucosal inflammation TRAE (grade 3-4) 0.97 [0.19, 4.88]< 10%1 study (1/-)51.4 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 2.95 [0.30, 28.63]< 10%1 study (1/-)17.7 %NAnot evaluable non important-
Neutropenia TRAE (grade 3-4) 0.97 [0.38, 2.51]< 10%1 study (1/-)52.4 %NAnot evaluable non important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 2.05 [0.89, 4.69]< 10%1 study (1/-)4.5 %NAnot evaluable non important-
Pancytopenia TRAE (grade 3-4) 0.24 [0.01, 5.38]< 10%1 study (1/-)81.2 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Peripheral oedema TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Pneumonia TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 0.48 [0.02, 14.54]< 10%1 study (1/-)65.9 %NAnot evaluable non important-
Pruritic rash TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Pyrexia TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 3.73 [1.02, 13.61]< 10%1 study (1/-)2.3 %NAnot evaluable non important-
Sepsis TRAE (grade 3-4) 0.97 [0.02, 49.28]< 10%1 study (1/-)50.5 %NAnot evaluable non important-
Skin exfoliation TRAE (grade 3-4) 1.95 [0.07, 58.51]< 10%1 study (1/-)35.2 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 2.00 [0.67, 5.97]< 10%1 study (1/-)10.8 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 0.48 [0.02, 14.54]< 10%1 study (1/-)65.9 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.32 [0.03, 3.11]< 10%1 study (1/-)83.5 %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.