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melanoma (ML), nivolumab 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) 0.59 [0.45, 0.77]< 172%5 studies (5/-)100.0 %lownot evaluable highcrucial-
deaths (OS) (extension) 0.63 [0.46, 0.85]< 184%3 studies (3/-)99.8 %lownot evaluable highimportant-
MFS 0.73 [0.56, 0.96]< 10%1 study (1/-)98.8 %NAnot evaluable important-
PFS (extension) 0.56 [0.40, 0.80]< 188%3 studies (3/-)99.9 %lownot evaluable highimportant-
progression or deaths (PFS) 0.53 [0.40, 0.70]< 180%4 studies (4/-)100.0 %lownot evaluable highimportant-
RFS (extension) 0.71 [0.59, 0.85]< 10%1 study (1/-)100.0 %NAnot evaluable important-
RFS/DFS 0.61 [0.49, 0.75]< 10%3 studies (3/-)100.0 %lownot evaluable highimportant-
DOR (extension) 3.45 [1.46, 8.18]> 10%1 study (1/-)99.8 %NAnot evaluable non important-
objective responses (ORR) 3.07 [1.93, 4.90]> 178%4 studies (4/-)100.0 %lownot evaluable highnon important-
objective responses (ORR) (extension) 4.57 [3.31, 6.32]> 150%3 studies (3/-)100.0 %lownot evaluable highnon important-

safety endpoints 00

AE (any grade) 0.63 [0.35, 1.17]< 10%2 studies (2/-)92.8 %lownot evaluable highnon important-
AE (grade 3-4) 0.48 [0.16, 1.41]< 195%2 studies (2/-)90.9 %lownot evaluable highnon important-
AE leading to death (grade 5) 0.98 [0.10, 9.49]< 10%3 studies (3/-)50.7 %lownot evaluable highnon important-
AE leading to treatment discontinuation (any grade) 1.26 [0.18, 8.98]< 196%4 studies (4/-)40.9 %lownot evaluable highnon important-
AE leading to treatment discontinuation (grade 3-4) 1.26 [0.15, 10.80]< 196%4 studies (4/-)41.7 %lownot evaluable highnon important-
SAE (any grade) 1.45 [0.55, 3.84]< 185%3 studies (3/-)22.7 %lownot evaluable highnon important-
SAE (grade 3-4) 1.77 [0.60, 5.28]< 185%3 studies (3/-)15.2 %lownot evaluable highnon important-
STRAE (any grade) 3.06 [0.84, 11.20]< 182%3 studies (3/-)4.6 %lownot evaluable highnon important-
STRAE (grade 3-4) 3.08 [0.73, 13.04]< 177%3 studies (3/-)6.3 %lownot evaluable highnon important-
TRAE (any grade) 1.47 [0.63, 3.44]< 191%6 studies (6/-)18.9 %lownot evaluable highnon important-
TRAE (grade 3-4) 1.52 [0.44, 5.28]< 198%6 studies (6/-)25.4 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 0.66 [0.13, 3.49]< 10%5 studies (5/-)68.5 %lowserious highnon important-
TRAE leading to discontinuation (any grade) 1.87 [0.31, 11.26]< 198%5 studies (5/-)24.8 %lownot evaluable highnon important-
TRAE leading to discontinuation (grade 3-4) 1.67 [0.24, 11.45]< 197%5 studies (5/-)30.1 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.73 [0.17, 3.12]< 10%6 studies (6/-)66.6 %lownot evaluable highnon important-
Acute kidney injury TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 1.41 [0.53, 3.74]< 10%5 studies (5/-)24.3 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 0.97 [0.10, 9.43]< 10%3 studies (3/-)50.9 %lownot evaluable highnon important-
Anaemia TRAE (grade 3-4) 1.29 [0.15, 11.17]< 10%3 studies (3/-)40.8 %lownot evaluable highnon important-
Arthralgia TRAE (grade 3-4) 1.08 [0.33, 3.55]< 10%6 studies (6/-)45.2 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 0.45 [0.12, 1.66]< 10%4 studies (4/-)88.3 %lownot evaluable highnon important-
Blood and lymphatic system disorders TRAE (grade 3-4) 3.02 [0.28, 33.13]< 10%2 studies (2/-)18.5 %lownot evaluable highnon important-
Blood creatinine increased TRAE (grade 3-4) 0.91 [0.02, 46.72]< 10%1 study (1/-)51.8 %NAnot evaluable non important-
Chills TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Colitis TRAE (grade 3-4) 1.53 [0.09, 25.31]< 189%4 studies (4/-)38.4 %lownot evaluable highnon important-
Constipation TRAE (grade 3-4) 1.00 [0.02, 50.40]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Cough TRAE (grade 3-4) 0.99 [0.20, 4.77]< 10%5 studies (5/-)50.7 %lownot evaluable highnon important-
Decreased appetite TRAE (grade 3-4) 1.56 [0.32, 7.63]< 10%5 studies (5/-)29.3 %lownot evaluable highnon important-
Diabetes TRAE (grade 3-4) 1.23 [0.17, 8.82]< 10%3 studies (3/-)41.8 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 0.86 [0.23, 3.28]< 185%6 studies (6/-)58.6 %lownot evaluable highnon important-
Dizziness TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 0.98 [0.17, 5.70]< 10%5 studies (5/-)50.8 %lownot evaluable highnon important-
Dysgeusia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dyspepsia TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Dyspnoea TRAE (grade 3-4) 1.93 [0.40, 9.20]< 10%4 studies (4/-)20.5 %lownot evaluable highnon important-
Endocrine disorders TRAE (grade 3-4) 4.00 [0.64, 25.16]< 10%2 studies (2/-)7.0 %lownot evaluable highnon important-
Eye disorders TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Fatigue TRAE (grade 3-4) 1.26 [0.50, 3.21]< 118%6 studies (6/-)31.2 %lownot evaluable highnon important-
Gastritis TRAE (grade 3-4) 2.32 [0.20, 26.84]< 10%2 studies (2/-)25.1 %lownot evaluable highnon important-
Gastrointestinal disorders TRAE (grade 3-4) 1.04 [0.04, 29.48]< 189%3 studies (3/-)49.0 %lownot evaluable highnon important-
General disorders and administration site conditions TRAE (grade 3-4) 2.32 [0.20, 26.84]< 10%2 studies (2/-)25.1 %lownot evaluable highnon important-
Headache TRAE (grade 3-4) 0.55 [0.15, 1.98]< 10%6 studies (6/-)82.0 %lownot evaluable highnon important-
Hepatitis TRAE (grade 3-4) 3.66 [1.06, 12.60]< 10%4 studies (4/-)2.0 %lownot evaluable highnon important-
Hepatobiliary disorders TRAE (grade 3-4) 1.42 [0.07, 29.90]< 191%3 studies (3/-)41.2 %lownot evaluable highnon important-
Hypersensitivity TRAE (grade 3-4) 1.49 [0.11, 19.39]< 10%2 studies (2/-)38.2 %lownot evaluable highnon important-
Hypertension TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Hyperthyroidism TRAE (grade 3-4) 2.24 [0.59, 8.46]< 10%6 studies (6/-)11.7 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 0.59 [0.14, 2.49]< 147%5 studies (5/-)76.2 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 0.88 [0.22, 3.53]< 10%6 studies (6/-)57.1 %lownot evaluable highnon important-
Increase AST TRAE (grade 3-4) 1.54 [0.36, 6.58]< 176%6 studies (6/-)28.0 %lownot evaluable highnon important-
Increased ALT TRAE (grade 3-4) 1.84 [0.42, 8.10]< 184%6 studies (6/-)21.1 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 1.84 [1.10, 3.09]< 116%4 studies (4/-)1.1 %lownot evaluable highnon important-
Infusion-related reactions TRAE (grade 3-4) 0.97 [0.10, 9.43]< 10%3 studies (3/-)50.9 %lownot evaluable highnon important-
Leucopenia TRAE (grade 3-4) 0.36 [0.05, 2.75]< 10%3 studies (3/-)83.5 %lownot evaluable highnon important-
Maculopapular rash TRAE (grade 3-4) 1.27 [0.38, 4.22]< 118%6 studies (6/-)35.1 %lownot evaluable highnon important-
Metabolism and nutrition disorders TRAE (grade 3-4) 1.29 [0.15, 11.24]< 10%2 studies (2/-)40.9 %lownot evaluable highnon important-
Musculoskeletal and connective tissue disorders TRAE (grade 3-4) 0.96 [0.03, 31.61]< 163%2 studies (2/-)50.8 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 1.12 [0.25, 4.97]< 10%5 studies (5/-)43.9 %lownot evaluable highnon important-
Myositis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Nausea TRAE (grade 3-4) 1.58 [0.39, 6.46]< 10%6 studies (6/-)26.2 %lownot evaluable highnon important-
Nervous system disorders TRAE (grade 3-4) 1.07 [0.16, 7.27]< 10%2 studies (2/-)47.3 %lownot evaluable highnon important-
Neutropenia TRAE (grade 3-4) 0.24 [0.03, 1.77]< 12%3 studies (3/-)91.9 %lownot evaluable highnon important-
Palmar-plantar erythrodysaesthesia syndrome TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Pancreatitis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Pancytopenia TRAE (grade 3-4) 0.16 [0.01, 3.29]< 10%1 study (1/-)87.9 %NAnot evaluable non important-
Paraesthesia TRAE (grade 3-4) 0.97 [0.10, 9.43]< 10%3 studies (3/-)50.9 %lownot evaluable highnon important-
Peripheral neuropathy TRAE (grade 3-4) 1.45 [0.11, 19.13]< 10%2 studies (2/-)39.0 %lownot evaluable highnon important-
Pneumonitis TRAE (grade 3-4) 1.59 [0.36, 7.01]< 10%4 studies (4/-)27.2 %lownot evaluable highnon important-
Pruritic rash TRAE (grade 3-4) 1.00 [0.06, 15.97]< 10%2 studies (2/-)50.1 %lownot evaluable highnon important-
Pruritus TRAE (grade 3-4) 1.28 [0.37, 4.42]< 14%6 studies (6/-)34.6 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 1.04 [0.27, 4.00]< 10%6 studies (6/-)47.9 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 0.95 [0.16, 5.74]< 170%4 studies (4/-)52.3 %lownot evaluable highnon important-
Renal and urinary disorders TRAE (grade 3-4) 1.00 [0.02, 50.62]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 0.37 [0.05, 2.77]< 10%3 studies (3/-)83.4 %lownot evaluable highnon important-
Sarcoidosis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 0.75 [0.09, 6.51]< 168%3 studies (3/-)60.2 %lownot evaluable highnon important-
Stomatitis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Thrombocytopenia TRAE (grade 3-4) 0.36 [0.03, 4.07]< 136%3 studies (3/-)79.4 %lownot evaluable highnon important-
Thyroiditis TRAE (grade 3-4) 1.22 [0.18, 8.03]< 10%4 studies (4/-)42.0 %lownot evaluable highnon important-
Uveitis TRAE (grade 3-4) 0.96 [0.06, 15.59]< 10%2 studies (2/-)51.1 %lownot evaluable highnon important-
Vitiligo TRAE (grade 3-4) 0.98 [0.19, 5.13]< 10%5 studies (5/-)50.7 %lownot evaluable highnon important-
Vomiting TRAE (grade 3-4) 2.04 [0.57, 7.31]< 10%5 studies (5/-)13.7 %lownot evaluable highnon important-
Weight decreased TRAE (grade 3-4) 0.79 [0.12, 5.23]< 10%4 studies (4/-)59.6 %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.