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metastatic/advanced NSCLC (mNSCLC) - 1st line (L1), anti-PD-(L)1 versus platinum-based chemotherapy, 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) 0.83 [0.73, 0.94]< 10%4 studies (4/-)99.9 %some concernnot evaluable moderatecrucial-
deaths (OS) (extension) 0.71 [0.45, 1.12]< 10%1 study (1/-)92.9 %NAnot evaluable important-
PFS (extension) 0.54 [0.35, 0.83]< 10%1 study (1/-)99.7 %NAnot evaluable important-
progression or deaths (PFS) 0.68 [0.61, 0.76]< 10%4 studies (4/-)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) 1.89 [1.30, 2.75]> 159%3 studies (3/-)100.0 %some concernnot evaluable moderatenon important-
objective responses (ORR) (extension) 2.80 [1.34, 5.83]> 10%1 study (1/-)99.7 %NAnot evaluable non important-

safety endpoints 00

AE (any grade) 5.12 [1.11, 23.56]< 10%1 study (1/-)1.8 %NAnot evaluable non important-
AE (grade 3-4) 1.37 [0.98, 1.90]< 10%1 study (1/-)3.3 %NAnot evaluable non important-
AE leading to death (grade 5) 2.59 [1.36, 4.92]< 10%1 study (1/-)0.2 %NAnot evaluable non important-
AE leading to treatment discontinuation (any grade) 2.09 [1.45, 3.02]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
SAE (any grade) 2.28 [1.66, 3.14]< 10%1 study (1/-)0.0 %NAnot evaluable non important-
STRAE (any grade) 2.17 [1.56, 3.01]< 10%3 studies (3/-)0.0 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 2.83 [1.13, 7.06]< 145%2 studies (2/-)1.3 %some concernnot evaluable moderatenon important-
TRAE (any grade) 2.03 [1.08, 3.81]< 150%3 studies (3/-)1.4 %some concernnot evaluable moderatenon important-
TRAE (grade 3-4) 1.85 [1.41, 2.42]< 113%3 studies (3/-)0.0 %some concernnot evaluable moderatenon important-
TRAE leading to death (grade 5) 1.48 [0.49, 4.46]< 10%3 studies (3/-)24.5 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (any grade) 0.86 [0.50, 1.46]< 10%2 studies (2/-)71.4 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (grade 3-4) 1.35 [0.29, 6.37]< 151%2 studies (2/-)35.2 %some concernnot evaluable moderatenon important-

TRAE (grade 3-4) endpoints 00

Acute kidney injury TRAE (grade 3-4) 4.32 [0.19, 97.73]< 10%1 study (1/-)18.2 %NAnot evaluable non important-
Adrenal insufficiency TRAE (grade 3-4) 2.00 [0.07, 59.91]< 10%1 study (1/-)34.7 %NAnot evaluable non important-
Alopecia TRAE (grade 3-4) 1.03 [0.06, 16.50]< 10%2 studies (2/-)49.3 %some concernnot evaluable moderatenon important-
Anaemia TRAE (grade 3-4) 1.12 [0.83, 1.52]< 10%3 studies (3/-)22.1 %some concernnot evaluable moderatenon important-
Arthralgia TRAE (grade 3-4) 1.00 [0.02, 50.55]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Asthenia TRAE (grade 3-4) 0.80 [0.31, 2.05]< 10%2 studies (2/-)67.7 %some concernnot evaluable moderatenon important-
Blood creatinine increased TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Colitis TRAE (grade 3-4) 8.08 [0.43, 153.53]< 10%1 study (1/-)8.4 %NAnot evaluable non important-
Constipation TRAE (grade 3-4) 0.47 [0.06, 3.37]< 10%3 studies (3/-)77.4 %some concernnot evaluable moderatenon important-
Decreased appetite TRAE (grade 3-4) 2.25 [0.86, 5.84]< 10%3 studies (3/-)4.9 %some concernnot evaluable moderatenon important-
Diabetes TRAE (grade 3-4) 6.05 [0.30, 121.16]< 10%1 study (1/-)12.2 %NAnot evaluable non important-
Diarrhoea TRAE (grade 3-4) 1.28 [0.55, 2.99]< 10%3 studies (3/-)28.4 %some concernnot evaluable moderatenon important-
Dizziness TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Dysgeusia TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Fatigue TRAE (grade 3-4) 2.08 [1.01, 4.27]< 10%3 studies (3/-)2.3 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 2.62 [1.11, 6.19]< 10%2 studies (2/-)1.4 %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) 1.00 [0.06, 16.05]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Hyperthyroidism TRAE (grade 3-4) 1.52 [0.12, 19.92]< 10%2 studies (2/-)37.6 %some concernnot evaluable moderatenon important-
Hypothyroidism TRAE (grade 3-4) 2.40 [0.21, 27.49]< 10%2 studies (2/-)24.2 %some concernnot evaluable moderatenon important-
Increase AST TRAE (grade 3-4) 1.05 [0.06, 17.21]< 10%1 study (1/-)48.6 %NAnot evaluable non important-
Increased ALT TRAE (grade 3-4) 1.05 [0.06, 17.21]< 10%1 study (1/-)48.6 %NAnot evaluable non important-
Increased lacrimation (TRAE grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Infusion-related reactions TRAE (grade 3-4) 1.53 [0.12, 20.15]< 10%2 studies (2/-)37.3 %some concernnot evaluable moderatenon important-
Leucopenia TRAE (grade 3-4) 1.48 [0.74, 2.94]< 10%2 studies (2/-)13.2 %some concernnot evaluable moderatenon important-
Myalgia TRAE (grade 3-4) 1.00 [0.02, 50.55]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Myositis TRAE (grade 3-4) 1.00 [0.02, 50.55]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Nausea TRAE (grade 3-4) 1.58 [0.60, 4.19]< 10%3 studies (3/-)18.0 %some concernnot evaluable moderatenon important-
Nephritis TRAE (grade 3-4) 1.00 [0.02, 50.55]< 10%1 study (1/-)50.0 %NAnot evaluable non important-
Neutropenia TRAE (grade 3-4) 1.00 [0.73, 1.38]< 10%3 studies (3/-)48.9 %some concernnot evaluable moderatenon important-
Pancreatitis TRAE (grade 3-4) 2.00 [0.07, 59.91]< 10%1 study (1/-)34.7 %NAnot evaluable non important-
Pancytopenia TRAE (grade 3-4) 0.52 [0.02, 15.84]< 10%1 study (1/-)64.4 %NAnot evaluable non important-
Peripheral neuropathy TRAE (grade 3-4) 2.01 [0.37, 11.06]< 10%1 study (1/-)21.2 %NAnot evaluable non important-
Peripheral oedema TRAE (grade 3-4) 1.05 [0.02, 53.86]< 10%1 study (1/-)49.0 %NAnot evaluable non important-
Peripheral sensory neuropathy TRAE (grade 3-4) 4.04 [0.45, 36.31]< 10%1 study (1/-)10.8 %NAnot evaluable non important-
Pneumonia TRAE (grade 3-4) 2.12 [0.07, 64.42]< 10%1 study (1/-)33.5 %NAnot evaluable non important-
Pneumonitis TRAE (grade 3-4) 1.74 [0.46, 6.55]< 10%2 studies (2/-)20.8 %some concernnot evaluable moderatenon important-
Pruritus TRAE (grade 3-4) 1.06 [0.07, 17.04]< 10%2 studies (2/-)48.4 %some concernnot evaluable moderatenon important-
Rash TRAE (grade 3-4) 2.07 [0.38, 11.33]< 10%3 studies (3/-)20.3 %some concernnot evaluable moderatenon important-
Sepsis TRAE (grade 3-4) 2.12 [0.07, 64.42]< 10%1 study (1/-)33.5 %NAnot evaluable non important-
Severe skin reaction TRAE (grade 3-4) 1.03 [0.11, 10.07]< 10%2 studies (2/-)48.9 %some concernnot evaluable moderatenon important-
Stomatitis TRAE (grade 3-4) 0.52 [0.02, 15.84]< 10%1 study (1/-)64.4 %NAnot evaluable non important-
Thrombocytopenia TRAE (grade 3-4) 1.16 [0.69, 1.95]< 10%2 studies (2/-)29.4 %some concernnot evaluable moderatenon important-
Vomiting TRAE (grade 3-4) 1.83 [0.56, 5.97]< 10%3 studies (3/-)15.7 %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.