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metastatic/advanced NSCLC (mNSCLC) - 1st line (L1), atezolizumab based treatment , 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) 0.82 [0.75, 0.89]< 10%6 studies (6/-)100.0 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.76 [0.53, 1.08]< 10%1 study (1/-)93.7 %NAnot evaluable important-
PFS (extension) 0.72 [0.60, 0.86]< 10%1 study (1/-)100.0 %NAnot evaluable important-
progression or deaths (PFS) 0.68 [0.60, 0.78]< 173%7 studies (7/-)100.0 %some concernnot evaluable moderateimportant-
DOR 2.27 [1.44, 3.57]< 10%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-
objective responses (ORR) 1.52 [1.17, 1.95]> 176%7 studies (7/-)99.9 %some concernnot evaluable moderatenon important-
objective responses (ORR) (extension) 1.68 [0.94, 3.01]> 10%1 study (1/-)95.9 %NAnot evaluable non important-

safety endpoints 00

AE (any grade) 1.07 [0.37, 3.10]< 166%4 studies (4/-)45.2 %some concernnot evaluable moderatenon important-
AE (grade 3-4) 1.01 [0.55, 1.86]< 193%4 studies (4/-)48.5 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.28 [0.78, 2.11]< 152%4 studies (4/-)16.1 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (any grade) 1.12 [0.62, 2.02]< 189%4 studies (4/-)35.4 %some concernnot evaluable moderatenon important-
SAE (any grade) 1.53 [1.11, 2.11]< 175%4 studies (4/-)0.5 %some concernnot evaluable moderatenon important-
STRAE (any grade) 1.38 [0.77, 2.47]< 186%4 studies (4/-)14.2 %some concernnot evaluable moderatenon important-
TRAE (any grade) 0.92 [0.33, 2.60]< 192%4 studies (4/-)56.2 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 0.93 [0.39, 2.23]< 196%4 studies (4/-)56.1 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.37 [0.68, 2.78]< 10%4 studies (4/-)18.8 %some concernnot evaluable moderatenon important-

TRAE (grade 3-4) endpoints 00

Adrenal insufficiency TRAE (grade 3-4) 1.32 [0.15, 11.35]< 10%2 studies (2/-)40.0 %some concernnot evaluable moderatenon important-
Alopecia TRAE (grade 3-4) 0.79 [0.08, 7.60]< 10%3 studies (3/-)58.1 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 1.27 [0.96, 1.68]< 125%3 studies (3/-)5.0 %some concernnot evaluable moderatenon important-
Arthralgia TRAE (grade 3-4) 0.78 [0.19, 3.17]< 10%2 studies (2/-)63.7 %some concernnot evaluable moderatenon important-
Asthenia TRAE (grade 3-4) 0.74 [0.39, 1.40]< 10%3 studies (3/-)82.1 %some concernnot evaluable moderatenon important-
Colitis TRAE (grade 3-4) 3.39 [0.92, 12.50]< 10%3 studies (3/-)3.3 %some concernnot evaluable moderatenon important-
Constipation TRAE (grade 3-4) 0.77 [0.10, 5.99]< 10%3 studies (3/-)59.7 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 1.96 [0.71, 5.43]< 129%3 studies (3/-)9.8 %some concernnot evaluable moderatenon important-
Diabetes TRAE (grade 3-4) 3.12 [0.29, 33.74]< 10%2 studies (2/-)17.7 %some concernnot evaluable moderatenon important-
Diarrhoea TRAE (grade 3-4) 1.65 [0.72, 3.78]< 149%3 studies (3/-)11.9 %some concernnot evaluable moderatenon important-
Dysgeusia TRAE (grade 3-4) 0.49 [0.01, 24.77]< 10%1 study (1/-)63.7 %NAnot evaluable non important-
Epistaxis TRAE (grade 3-4) 8.09 [0.43, 153.59]< 10%1 study (1/-)8.4 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 1.27 [0.81, 1.99]< 10%3 studies (3/-)15.1 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 1.78 [1.04, 3.05]< 118%2 studies (2/-)1.7 %some concernnot evaluable moderatenon important-
Guillain-Barré syndrome TRAE (grade 3-4) 1.00 [0.02, 50.55]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Hepatitis TRAE (grade 3-4) 5.48 [1.30, 23.18]< 11%3 studies (3/-)1.1 %some concernnot evaluable moderatenon important-
Hypertension TRAE (grade 3-4) 1.00 [0.57, 1.78]< 10%1 study (1/-)49.6 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 1.62 [0.21, 12.58]< 10%3 studies (3/-)32.3 %some concernnot evaluable moderatenon important-
Hypophysitis TRAE (grade 3-4) 2.01 [0.07, 60.02]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Hypothyroidism TRAE (grade 3-4) 2.18 [0.30, 15.78]< 10%3 studies (3/-)22.1 %some concernnot evaluable moderatenon important-
Increase AST TRAE (grade 3-4) 4.04 [0.45, 36.32]< 10%1 study (1/-)10.8 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 4.04 [0.45, 36.32]< 10%1 study (1/-)10.8 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 0.96 [0.06, 15.37]< 10%2 studies (2/-)51.2 %some concernnot evaluable moderatenon important-
Leucopenia TRAE (grade 3-4) 1.53 [0.83, 2.81]< 10%2 studies (2/-)8.7 %some concernnot evaluable moderatenon important-
Myalgia TRAE (grade 3-4) 1.66 [0.21, 12.91]< 10%2 studies (2/-)31.5 %some concernnot evaluable moderatenon important-
Myositis TRAE (grade 3-4) 1.49 [0.11, 19.42]< 10%2 studies (2/-)38.2 %some concernnot evaluable moderatenon important-
Nausea TRAE (grade 3-4) 2.00 [1.06, 3.77]< 10%3 studies (3/-)1.6 %some concernnot evaluable moderatenon important-
Nephritis TRAE (grade 3-4) 1.49 [0.11, 19.42]< 10%2 studies (2/-)38.2 %some concernnot evaluable moderatenon important-
Neutropenia TRAE (grade 3-4) 1.12 [0.90, 1.39]< 10%3 studies (3/-)15.1 %some concernnot evaluable moderatenon important-
Pancreatitis TRAE (grade 3-4) 2.93 [0.30, 28.98]< 10%2 studies (2/-)18.0 %some concernnot evaluable moderatenon important-
Paraesthesia TRAE (grade 3-4) 0.50 [0.02, 14.97]< 10%1 study (1/-)65.3 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 1.37 [0.62, 3.02]< 10%2 studies (2/-)21.8 %some concernnot evaluable moderatenon important-
Peripheral sensory neuropathy TRAE (grade 3-4) 4.04 [0.45, 36.31]< 10%1 study (1/-)10.8 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 2.31 [0.84, 6.37]< 10%3 studies (3/-)5.3 %some concernnot evaluable moderatenon important-
Rash TRAE (grade 3-4) 2.28 [0.63, 8.28]< 10%3 studies (3/-)10.6 %some concernnot evaluable moderatenon important-
Sepsis TRAE (grade 3-4) 2.01 [0.07, 60.02]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 1.00 [0.02, 50.55]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 4.04 [0.45, 36.32]< 10%1 study (1/-)10.8 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 1.21 [0.85, 1.71]< 10%3 studies (3/-)14.7 %some concernnot evaluable moderatenon important-
Vomiting TRAE (grade 3-4) 1.48 [0.65, 3.36]< 10%3 studies (3/-)17.8 %some concernnot evaluable moderatenon important-

AE (grade 3-4) endpoints 00

hepatitis (Autoimmune) AE (grade 3-4) 0.98 [0.03, 29.35]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Abdominal pain AE (grade 3-4) 1.23 [0.24, 6.38]< 10%1 study (1/-)40.4 %NAnot evaluable non important-
Agranulocytosis (AE grade 3-4) 0.24 [0.01, 7.31]< 10%1 study (1/-)78.8 %NAnot evaluable non important-
Alopecia AE (grade 3-4) 0.49 [0.01, 24.77]< 10%1 study (1/-)63.7 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 0.35 [0.02, 6.18]< 197%2 studies (2/-)75.9 %some concernnot evaluable moderatenon important-
Arthralgia AE (grade 3-4) 7.97 [0.46, 139.30]< 10%1 study (1/-)8.0 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 0.88 [0.21, 3.64]< 155%2 studies (2/-)56.9 %some concernnot evaluable moderatenon important-
Back pain AE (grade 3-4) 3.97 [0.49, 31.97]< 10%1 study (1/-)9.9 %NAnot evaluable non important-
Blood creatinine increased AE (grade 3-4) 1.97 [0.09, 43.77]< 10%1 study (1/-)33.7 %NAnot evaluable non important-
Colitis AE (grade 3-4) 2.96 [0.15, 59.25]< 10%1 study (1/-)24.2 %NAnot evaluable non important-
Constipation AE (grade 3-4) 1.97 [0.43, 9.07]< 10%2 studies (2/-)19.4 %some concernnot evaluable moderatenon important-
Cough AE (grade 3-4) 2.40 [0.25, 22.76]< 10%2 studies (2/-)22.4 %some concernnot evaluable moderatenon important-
Decreased appetite AE (grade 3-4) 1.13 [0.41, 3.16]< 10%2 studies (2/-)40.6 %some concernnot evaluable moderatenon important-
Diabetes mellitus AE (grade 3-4) 1.97 [0.09, 43.77]< 10%1 study (1/-)33.7 %NAnot evaluable non important-
Diarrhoea AE (grade 3-4) 0.82 [0.42, 1.58]< 10%2 studies (2/-)72.5 %some concernnot evaluable moderatenon important-
Dizziness AE (grade 3-4) 0.49 [0.03, 7.86]< 10%1 study (1/-)69.1 %NAnot evaluable non important-
Dry skin AE (grade 3-4) 0.24 [0.01, 7.31]< 10%1 study (1/-)78.8 %NAnot evaluable non important-
Dysgeusia AE (grade 3-4) 0.49 [0.01, 24.77]< 10%1 study (1/-)63.7 %NAnot evaluable non important-
Dyspnoea AE (grade 3-4) 5.20 [1.39, 19.45]< 10%2 studies (2/-)0.7 %some concernnot evaluable moderatenon important-
Epistaxis AE (grade 3-4) 0.49 [0.03, 7.86]< 10%1 study (1/-)69.1 %NAnot evaluable non important-
Fatigue AE (grade 3-4) 0.76 [0.19, 2.97]< 163%2 studies (2/-)65.5 %some concernnot evaluable moderatenon important-
Febrile neutropenia AE (grade 3-4) 0.29 [0.02, 4.63]< 172%2 studies (2/-)80.7 %some concernnot evaluable moderatenon important-
Gastritis AE (grade 3-4) 1.97 [0.09, 43.77]< 10%1 study (1/-)33.7 %NAnot evaluable non important-
Headache AE (grade 3-4) 0.98 [0.03, 29.35]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Hypertension AE (grade 3-4) 1.00 [0.30, 3.31]< 10%2 studies (2/-)50.2 %some concernnot evaluable moderatenon important-
Hyperthyroidism AE (grade 3-4) 0.49 [0.03, 7.86]< 10%1 study (1/-)69.1 %NAnot evaluable non important-
Hypothyroidism AE (grade 3-4) 1.97 [0.09, 43.77]< 10%1 study (1/-)33.7 %NAnot evaluable non important-
Increase AST AE (grade 3-4) 1.71 [0.40, 7.37]< 129%2 studies (2/-)23.7 %some concernnot evaluable moderatenon important-
Increased ALT AE (grade 3-4) 1.49 [0.26, 8.74]< 152%2 studies (2/-)32.8 %some concernnot evaluable moderatenon important-
Infusion-related reaction AE (grade 3-4) 0.98 [0.03, 29.35]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Leucopenia AE (grade 3-4) 0.79 [0.13, 4.82]< 161%2 studies (2/-)60.2 %some concernnot evaluable moderatenon important-
Myalgia AE (grade 3-4) 0.98 [0.03, 29.35]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Nausea AE (grade 3-4) 0.67 [0.08, 5.36]< 169%2 studies (2/-)64.8 %some concernnot evaluable moderatenon important-
Neutropenia AE (grade 3-4) 0.22 [0.01, 7.51]< 196%2 studies (2/-)79.7 %some concernnot evaluable moderatenon important-
Pancytopenia (AE grade 3-4) 0.48 [0.10, 2.18]< 10%2 studies (2/-)83.0 %some concernnot evaluable moderatenon important-
Paraesthesia AE (grade 3-4) 1.97 [0.09, 43.77]< 10%1 study (1/-)33.7 %NAnot evaluable non important-
Peripheral neuropathy AE (grade 3-4) 0.73 [0.12, 4.42]< 10%1 study (1/-)63.2 %NAnot evaluable non important-
Peripheral oedema AE (grade 3-4) 0.73 [0.12, 4.42]< 10%1 study (1/-)63.2 %NAnot evaluable non important-
Peripheral sensory neuropathy AE (grade 3-4) 0.98 [0.24, 3.96]< 10%1 study (1/-)51.1 %NAnot evaluable non important-
Pneumonia AE (grade 3-4) 1.09 [0.57, 2.07]< 112%2 studies (2/-)40.1 %some concernnot evaluable moderatenon important-
Pneumonitis AE (grade 3-4) 0.24 [0.01, 7.31]< 10%1 study (1/-)78.8 %NAnot evaluable non important-
Pruritus AE (grade 3-4) 0.98 [0.03, 29.35]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Pyrexia AE (grade 3-4) 0.67 [0.06, 7.42]< 10%2 studies (2/-)62.7 %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.