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melanoma (ML), anti-PD-(L)1 versus 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) 0.74 [0.62, 0.88]< 143%5 studies (5/-)100.0 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.66 [0.58, 0.75]< 10%3 studies (3/-)100.0 %some concernnot evaluable moderateimportant-
MFS 0.73 [0.56, 0.96]< 10%1 study (1/-)98.8 %NAnot evaluable important-
PFS (extension) 0.58 [0.52, 0.65]< 10%3 studies (3/-)100.0 %some concernnot evaluable moderateimportant-
progression or deaths (PFS) 0.68 [0.50, 0.94]< 185%4 studies (4/-)99.1 %some concernnot evaluable moderateimportant-
RFS (extension) 0.71 [0.59, 0.85]< 10%1 study (1/-)100.0 %NAnot evaluable important-
RFS/DFS 0.65 [0.51, 0.83]< 10%1 study (1/-)100.0 %NAnot evaluable important-
DCR 0.91 [0.63, 1.32]> 10%1 study (1/-)31.6 %NAnot evaluable non important-
objective responses (ORR) 2.43 [1.10, 5.41]> 192%4 studies (4/-)98.6 %some concernnot evaluable moderatenon important-
objective responses (ORR) (extension) 3.54 [2.46, 5.10]> 10%1 study (1/-)100.0 %NAnot evaluable non important-

safety endpoints 00

AE (any grade) 2.52 [0.09, 68.35]< 193%2 studies (2/-)29.4 %lownot evaluable highnon important-
AE (grade 3-4) 1.05 [0.08, 14.50]< 199%2 studies (2/-)48.5 %lownot evaluable highnon important-
AE leading to death (grade 5) 1.39 [0.43, 4.44]< 10%1 study (1/-)29.1 %NAnot evaluable non important-
AE leading to treatment discontinuation (any grade) 0.15 [0.10, 0.21]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
AE leading to treatment discontinuation (grade 3-4) 0.11 [0.07, 0.18]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
STRAE (any grade) 0.65 [0.46, 0.92]< 10%2 studies (2/-)99.3 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
TRAE (any grade) 0.84 [0.41, 1.74]< 191%4 studies (4/-)67.9 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 0.55 [0.26, 1.18]< 193%4 studies (4/-)93.8 %lownot evaluable highnon important-
TRAE leading to death (grade 5) 0.74 [0.13, 4.33]< 10%4 studies (4/-)63.1 %lownot evaluable highnon important-
TRAE leading to discontinuation (any grade) 0.52 [0.17, 1.63]< 195%4 studies (4/-)86.9 %lownot evaluable highnon important-
TRAE leading to discontinuation (grade 3-4) 0.29 [0.07, 1.28]< 187%4 studies (4/-)94.8 %lownot evaluable highnon important-

TRAE (grade 3-4) endpoints 00

Abdominal pain TRAE (grade 3-4) 0.51 [0.09, 2.99]< 10%4 studies (4/-)77.1 %lownot evaluable highnon important-
Adrenal insufficiency TRAE (grade 3-4) 0.79 [0.20, 3.18]< 10%2 studies (2/-)62.9 %lownot evaluable highnon important-
Alopecia TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 1.16 [0.16, 8.29]< 10%2 studies (2/-)44.1 %some concernnot evaluable moderatenon important-
Arthralgia TRAE (grade 3-4) 0.83 [0.17, 4.14]< 10%4 studies (4/-)58.8 %lownot evaluable highnon important-
Asthenia TRAE (grade 3-4) 0.35 [0.10, 1.19]< 10%4 studies (4/-)95.4 %lownot evaluable highnon important-
Chills TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Colitis TRAE (grade 3-4) 0.22 [0.12, 0.41]< 14%3 studies (3/-)100.0 %some concernnot evaluable moderatenon important-
Constipation TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Cough TRAE (grade 3-4) 1.77 [0.22, 13.99]< 10%3 studies (3/-)29.5 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 0.72 [0.08, 6.17]< 10%3 studies (3/-)61.7 %some concernnot evaluable moderatenon important-
Diabetes TRAE (grade 3-4) 1.93 [0.17, 21.31]< 10%2 studies (2/-)29.8 %lownot evaluable highnon important-
Diarrhoea TRAE (grade 3-4) 0.39 [0.17, 0.86]< 162%4 studies (4/-)99.0 %lownot evaluable highnon important-
Dry skin TRAE (grade 3-4) 0.95 [0.10, 9.11]< 10%3 studies (3/-)51.9 %some concernnot evaluable moderatenon important-
Dyspnoea TRAE (grade 3-4) 0.94 [0.15, 5.80]< 10%3 studies (3/-)52.5 %some concernnot evaluable moderatenon important-
Fatigue TRAE (grade 3-4) 0.68 [0.28, 1.63]< 10%4 studies (4/-)80.6 %lownot evaluable highnon important-
Gastrointestinal disorders TRAE (grade 3-4) 0.10 [0.05, 0.20]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Headache TRAE (grade 3-4) 0.31 [0.07, 1.40]< 10%4 studies (4/-)93.5 %lownot evaluable highnon important-
Hepatitis TRAE (grade 3-4) 3.06 [0.72, 13.07]< 10%3 studies (3/-)6.6 %some concernnot evaluable moderatenon important-
Hepatobiliary disorders TRAE (grade 3-4) 0.15 [0.07, 0.32]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Hypersensitivity TRAE (grade 3-4) 2.01 [0.07, 59.97]< 10%1 study (1/-)34.6 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 0.69 [0.13, 3.61]< 10%4 studies (4/-)66.7 %lownot evaluable highnon important-
Hypophysitis TRAE (grade 3-4) 0.22 [0.08, 0.63]< 10%4 studies (4/-)99.8 %lownot evaluable highnon important-
Hypothyroidism TRAE (grade 3-4) 0.83 [0.17, 4.12]< 10%4 studies (4/-)59.0 %lownot evaluable highnon important-
Increase AST TRAE (grade 3-4) 0.34 [0.09, 1.36]< 144%4 studies (4/-)93.5 %lownot evaluable highnon important-
Increased ALT TRAE (grade 3-4) 0.32 [0.15, 0.69]< 16%4 studies (4/-)99.8 %lownot evaluable highnon important-
Increased lipase level TRAE (grade 3-4) 1.17 [0.53, 2.56]< 10%1 study (1/-)35.1 %NAnot evaluable non important-
Maculopapular rash TRAE (grade 3-4) 0.52 [0.11, 2.51]< 120%4 studies (4/-)79.1 %lownot evaluable highnon important-
Myalgia TRAE (grade 3-4) 0.94 [0.15, 5.80]< 10%3 studies (3/-)52.6 %some concernnot evaluable moderatenon important-
Myositis TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Nausea TRAE (grade 3-4) 0.74 [0.13, 4.35]< 10%4 studies (4/-)62.9 %lownot evaluable highnon important-
Nephritis TRAE (grade 3-4) 0.46 [0.04, 5.09]< 10%2 studies (2/-)73.5 %some concernnot evaluable moderatenon important-
Neutropenia TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Paraesthesia TRAE (grade 3-4) 0.46 [0.04, 5.09]< 10%2 studies (2/-)73.5 %some concernnot evaluable moderatenon important-
Pneumonitis TRAE (grade 3-4) 0.80 [0.15, 4.36]< 10%3 studies (3/-)60.3 %some concernnot evaluable moderatenon important-
Pruritic rash TRAE (grade 3-4) 0.95 [0.10, 9.11]< 10%3 studies (3/-)51.9 %some concernnot evaluable moderatenon important-
Pruritus TRAE (grade 3-4) 0.47 [0.09, 2.40]< 10%4 studies (4/-)81.7 %lownot evaluable highnon important-
Pyrexia TRAE (grade 3-4) 0.51 [0.09, 2.99]< 10%4 studies (4/-)77.1 %lownot evaluable highnon important-
Rash TRAE (grade 3-4) 0.35 [0.15, 0.85]< 10%4 studies (4/-)99.0 %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) 0.12 [0.01, 2.36]< 10%1 study (1/-)91.5 %NAnot evaluable non important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 0.18 [0.07, 0.46]< 10%1 study (1/-)100.0 %NAnot evaluable non important-
Thyroiditis TRAE (grade 3-4) 0.99 [0.02, 50.24]< 10%1 study (1/-)50.1 %NAnot evaluable non important-
Uveitis TRAE (grade 3-4) 0.92 [0.06, 14.79]< 10%2 studies (2/-)52.3 %some concernnot evaluable moderatenon important-
Vitiligo TRAE (grade 3-4) 1.99 [0.07, 59.55]< 10%1 study (1/-)34.8 %NAnot evaluable non important-
Vomiting TRAE (grade 3-4) 1.18 [0.18, 7.79]< 10%3 studies (3/-)43.1 %some concernnot evaluable moderatenon important-
Weight decreased TRAE (grade 3-4) 0.47 [0.07, 3.36]< 10%3 studies (3/-)77.2 %some concernnot evaluable moderatenon important-

AE (grade 3-4) endpoints 00

Abdominal pain AE (grade 3-4) 0.98 [0.14, 7.03]< 10%1 study (1/-)50.7 %NAnot evaluable non important-
Anaemia AE (grade 3-4) 1.74 [0.50, 6.04]< 10%1 study (1/-)19.1 %NAnot evaluable non important-
Arthralgia AE (grade 3-4) 0.98 [0.02, 49.71]< 10%1 study (1/-)50.4 %NAnot evaluable non important-
Asthenia AE (grade 3-4) 1.74 [0.50, 6.04]< 10%1 study (1/-)19.1 %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.