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renal cell cancer (RCC), 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) 0.68 [0.49, 0.95]< 10%1 study (1/-)98.9 %NAnot evaluable crucial-
deaths (OS) (extension) 0.71 [0.59, 0.86]< 10%1 study (1/-)100.0 %NAnot evaluable important-
PFS (extension) 0.85 [0.73, 0.98]< 10%1 study (1/-)98.5 %NAnot evaluable important-
progression or deaths (PFS) 0.98 [0.79, 1.22]< 10%1 study (1/-)57.1 %NAnot evaluable important-
objective responses (ORR) 1.35 [1.05, 1.73]> 10%1 study (1/-)99.1 %NAnot evaluable non important-
objective responses (ORR) (extension) 1.36 [1.06, 1.74]> 10%1 study (1/-)99.3 %NAnot evaluable non important-

safety endpoints 00

TRAE (any grade) 0.41 [0.22, 0.76]< 10%1 study (1/-)99.7 %NAnot evaluable non important-
TRAE (grade 3-4) 0.49 [0.39, 0.63]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
TRAE leading to death (grade 5) 1.97 [0.59, 6.58]< 10%1 study (1/-)13.6 %NAnot evaluable non important-
TRAE leading to discontinuation (any grade) 1.98 [1.42, 2.74]< 10%1 study (1/-)0.0 %NAnot evaluable non important-

TRAE (grade 3-4) endpoints 00

Acute kidney injury TRAE (grade 3-4) 1.31 [0.29, 5.86]< 10%1 study (1/-)36.4 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 21.94 [1.29, 374.25]< 10%1 study (1/-)1.7 %NAnot evaluable non important-
Anaemia TRAE (grade 3-4) 0.08 [0.02, 0.35]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 0.75 [0.33, 1.72]< 10%1 study (1/-)75.3 %NAnot evaluable non important-
Blister TRAE (grade 3-4) 0.16 [0.01, 3.25]< 10%1 study (1/-)88.0 %NAnot evaluable non important-
Blood creatinine increased TRAE (grade 3-4) 0.49 [0.04, 5.40]< 10%1 study (1/-)71.9 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 21.94 [1.29, 374.25]< 10%1 study (1/-)1.7 %NAnot evaluable non important-
Decreased appetite TRAE (grade 3-4) 1.14 [0.38, 3.42]< 10%1 study (1/-)40.6 %NAnot evaluable non important-
Diabetes TRAE (grade 3-4) 11.86 [0.66, 212.80]< 10%1 study (1/-)4.8 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 0.65 [0.37, 1.14]< 10%1 study (1/-)93.2 %NAnot evaluable non important-
Dysgeusia TRAE (grade 3-4) 0.49 [0.02, 14.59]< 10%1 study (1/-)65.8 %NAnot evaluable non important-
Dyspepsia TRAE (grade 3-4) 0.98 [0.02, 49.38]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Eczema TRAE (grade 3-4) 0.98 [0.02, 49.38]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Endocrine disorders TRAE (grade 3-4) 39.87 [5.45, 291.45]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
Erythema TRAE (grade 3-4) 0.98 [0.02, 49.38]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 0.44 [0.26, 0.72]< 10%1 study (1/-)99.9 %NAnot evaluable non important-
Gastrointestinal disorders TRAE (grade 3-4) 0.84 [0.50, 1.43]< 10%1 study (1/-)73.4 %NAnot evaluable non important-
Hepatobiliary disorders TRAE (grade 3-4) 2.42 [1.41, 4.14]< 10%1 study (1/-)0.1 %NAnot evaluable non important-
Hypertension TRAE (grade 3-4) 0.04 [0.01, 0.10]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 3.92 [0.18, 87.20]< 10%1 study (1/-)19.7 %NAnot evaluable non important-
Hypophysitis TRAE (grade 3-4) 30.14 [1.80, 505.79]< 10%1 study (1/-)1.0 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 1.96 [0.18, 21.68]< 10%1 study (1/-)29.3 %NAnot evaluable non important-
Increase AST TRAE (grade 3-4) 2.86 [1.20, 6.83]< 10%1 study (1/-)0.9 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 3.15 [1.47, 6.75]< 10%1 study (1/-)0.2 %NAnot evaluable non important-
Increased lipase level TRAE (grade 3-4) 1.61 [1.04, 2.49]< 10%1 study (1/-)1.6 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 7.93 [0.99, 63.59]< 10%1 study (1/-)2.6 %NAnot evaluable non important-
Mucosal inflammation TRAE (grade 3-4) 0.06 [0.01, 0.48]< 10%1 study (1/-)99.6 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 1.12 [0.40, 3.11]< 10%1 study (1/-)41.4 %NAnot evaluable non important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.02 [0.00, 0.13]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Pruritic rash TRAE (grade 3-4) 1.96 [0.07, 58.49]< 10%1 study (1/-)35.1 %NAnot evaluable non important-
Pruritus generalised TRAE (grade 3-4) 0.98 [0.02, 49.38]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Pruritus TRAE (grade 3-4) 5.90 [0.29, 117.97]< 10%1 study (1/-)12.6 %NAnot evaluable non important-
Rash TRAE (grade 3-4) 17.88 [1.03, 309.26]< 10%1 study (1/-)2.5 %NAnot evaluable non important-
Renal and urinary disorders TRAE (grade 3-4) 1.14 [0.38, 3.42]< 10%1 study (1/-)40.6 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 11.86 [0.66, 212.80]< 10%1 study (1/-)4.8 %NAnot evaluable non important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 0.36 [0.21, 0.60]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Skin exfoliation TRAE (grade 3-4) 0.98 [0.02, 49.38]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Skin hypopigmentation TRAE (grade 3-4) 0.98 [0.02, 49.38]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 0.03 [0.00, 0.57]< 10%1 study (1/-)99.0 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 0.02 [0.00, 0.34]< 10%1 study (1/-)99.6 %NAnot evaluable non important-
Thyroiditis TRAE (grade 3-4) 1.96 [0.07, 58.49]< 10%1 study (1/-)35.1 %NAnot evaluable non important-
Urticaria TRAE (grade 3-4) 1.96 [0.07, 58.49]< 10%1 study (1/-)35.1 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 0.39 [0.12, 1.24]< 10%1 study (1/-)94.5 %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.