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metastatic/advanced NSCLC (mNSCLC) - 1st line (L1), anti-PD-(L)1 , 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) 0.79 [0.73, 0.87]< 161%17 studies (17/-)100.0 %some concernlow moderatecrucial-
deaths (OS) (extension) 0.69 [0.58, 0.81]< 157%5 studies (5/-)100.0 %some concernnot evaluable moderateimportant-
PFS (extension) 0.64 [0.44, 0.91]< 194%5 studies (5/-)99.3 %some concernnot evaluable moderateimportant-
progression or deaths (PFS) 0.70 [0.61, 0.80]< 187%18 studies (18/-)100.0 %some concerncritical moderateimportant-
DOR 2.27 [1.44, 3.57]< 10%2 studies (2/-)0.0 %some concernnot evaluable moderatenon important-
objective responses (ORR) 1.60 [1.29, 1.98]> 184%17 studies (17/-)100.0 %some concernlow moderatenon important-
objective responses (ORR) (extension) 2.00 [1.13, 3.54]> 188%5 studies (5/-)99.2 %some concernnot evaluable moderatenon important-

safety endpoints 00

AE (any grade) 0.80 [0.38, 1.68]< 178%9 studies (9/-)72.3 %some concernserious moderatenon important-
AE (grade 3-4) 0.83 [0.56, 1.25]< 192%9 studies (9/-)81.1 %some concernnot evaluable moderatenon important-
AE leading to death (grade 5) 1.09 [0.79, 1.51]< 141%9 studies (9/-)29.6 %some concernserious moderatenon important-
AE leading to treatment discontinuation (any grade) 1.24 [0.86, 1.80]< 183%9 studies (9/-)12.7 %some concernnot evaluable moderatenon important-
AE leading to treatment discontinuation (grade 3-4) 1.43 [0.89, 2.29]< 161%4 studies (4/-)7.2 %lownot evaluable highnon important-
SAE (any grade) 1.48 [1.12, 1.95]< 169%5 studies (5/-)0.3 %some concernnot evaluable moderatenon important-
STRAE (any grade) 1.26 [0.86, 1.84]< 181%9 studies (9/-)11.7 %some concernnot evaluable moderatenon important-
STRAE (grade 3-4) 1.16 [0.62, 2.15]< 179%5 studies (5/-)32.1 %some concernnot evaluable moderatenon important-
TRAE (any grade) 0.59 [0.31, 1.10]< 193%10 studies (10/-)95.1 %some concerncritical moderatenon important-
TRAE (grade 3-4) 0.68 [0.37, 1.26]< 196%10 studies (10/-)88.9 %some concernlow moderatenon important-
TRAE leading to death (grade 5) 1.15 [0.75, 1.76]< 10%10 studies (10/-)25.7 %some concernlow moderatenon important-
TRAE leading to discontinuation (any grade) 0.78 [0.62, 0.98]< 10%6 studies (6/-)98.2 %some concernnot evaluable moderatenon important-
TRAE leading to discontinuation (grade 3-4) 1.09 [0.82, 1.45]< 10%6 studies (6/-)26.9 %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) 1.36 [0.35, 5.34]< 10%5 studies (5/-)32.8 %some concernnot evaluable moderatenon important-
Alopecia TRAE (grade 3-4) 0.48 [0.12, 1.95]< 10%7 studies (7/-)84.6 %some concernserious moderatenon important-
Anaemia TRAE (grade 3-4) 0.35 [0.16, 0.76]< 191%9 studies (9/-)99.6 %some concernserious moderatenon important-
Arthralgia TRAE (grade 3-4) 0.80 [0.21, 2.99]< 10%3 studies (3/-)63.1 %some concernnot evaluable moderatenon important-
Asthenia TRAE (grade 3-4) 0.52 [0.29, 0.95]< 115%7 studies (7/-)98.3 %some concernnot evaluable moderatenon important-
Blood creatinine increased TRAE (grade 3-4) 1.00 [0.13, 7.77]< 10%3 studies (3/-)50.1 %some concernnot evaluable moderatenon important-
Colitis TRAE (grade 3-4) 3.11 [1.23, 7.86]< 10%8 studies (8/-)0.8 %some concernnot evaluable moderatenon important-
Constipation TRAE (grade 3-4) 0.68 [0.20, 2.27]< 10%9 studies (9/-)73.5 %some concernserious moderatenon important-
Decreased appetite TRAE (grade 3-4) 0.95 [0.46, 1.96]< 141%9 studies (9/-)55.4 %some concernnot evaluable moderatenon important-
Diabetes TRAE (grade 3-4) 1.85 [0.39, 8.75]< 10%5 studies (5/-)21.9 %some concernserious moderatenon important-
Diarrhoea TRAE (grade 3-4) 1.35 [0.87, 2.09]< 10%11 studies (11/-)9.3 %some concernlow 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) 0.84 [0.12, 5.97]< 10%4 studies (4/-)57.0 %some concernnot evaluable moderatenon 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) 0.91 [0.54, 1.51]< 145%9 studies (9/-)64.6 %some concernnot evaluable moderatenon important-
Febrile neutropenia TRAE (grade 3-4) 1.75 [1.10, 2.78]< 10%3 studies (3/-)0.9 %some concernnot evaluable moderatenon important-
Gastrointestinal disorders TRAE (grade 3-4) 1.19 [0.36, 3.94]< 10%1 study (1/-)39.0 %NAnot evaluable non 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) 4.87 [1.69, 14.02]< 10%7 studies (7/-)0.2 %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) 1.11 [0.34, 3.64]< 10%10 studies (10/-)42.9 %some concerncritical moderatenon important-
Hypophysitis TRAE (grade 3-4) 1.90 [0.40, 8.99]< 10%5 studies (5/-)21.0 %some concernserious moderatenon important-
Hypothyroidism TRAE (grade 3-4) 1.62 [0.55, 4.71]< 10%11 studies (11/-)19.0 %some concerncritical moderatenon important-
Increase AST TRAE (grade 3-4) 2.07 [0.70, 6.13]< 10%5 studies (5/-)9.4 %some concernnot evaluable moderatenon important-
Increased ALT TRAE (grade 3-4) 2.10 [0.98, 4.51]< 10%6 studies (6/-)2.8 %some concernnot evaluable moderatenon 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) 0.55 [0.15, 2.03]< 10%6 studies (6/-)81.4 %some concernserious moderatenon important-
Leucopenia TRAE (grade 3-4) 0.65 [0.18, 2.35]< 161%5 studies (5/-)74.1 %some concernnot evaluable moderatenon important-
Maculopapular rash TRAE (grade 3-4) 1.95 [0.18, 21.58]< 10%2 studies (2/-)29.4 %some concernnot evaluable moderatenon important-
Mucosal inflammation TRAE (grade 3-4) 0.98 [0.02, 49.83]< 10%1 study (1/-)50.3 %NAnot evaluable non important-
Myalgia TRAE (grade 3-4) 1.73 [0.30, 10.01]< 10%3 studies (3/-)27.1 %some concernnot evaluable moderatenon important-
Myocarditis TRAE (grade 3-4) 1.94 [0.06, 57.80]< 10%1 study (1/-)35.4 %NAnot evaluable non important-
Myositis TRAE (grade 3-4) 1.05 [0.16, 6.91]< 10%4 studies (4/-)48.0 %some concernnot evaluable moderatenon important-
Nausea TRAE (grade 3-4) 0.83 [0.37, 1.88]< 148%9 studies (9/-)67.2 %some concernserious moderatenon important-
Nephritis TRAE (grade 3-4) 1.96 [0.52, 7.32]< 10%7 studies (7/-)16.0 %some concernserious moderatenon important-
Neutropenia TRAE (grade 3-4) 0.48 [0.25, 0.92]< 183%9 studies (9/-)98.7 %some concernserious moderatenon important-
Pancreatitis TRAE (grade 3-4) 2.11 [0.47, 9.43]< 10%5 studies (5/-)16.5 %some concernserious moderatenon important-
Pancytopenia TRAE (grade 3-4) 0.52 [0.02, 15.84]< 10%1 study (1/-)64.4 %NAnot evaluable non 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) 1.16 [0.56, 2.42]< 10%5 studies (5/-)34.3 %some concernnot evaluable moderatenon important-
Peripheral oedema TRAE (grade 3-4) 1.02 [0.06, 16.38]< 10%2 studies (2/-)49.5 %some concernnot evaluable moderatenon important-
Peripheral sensory neuropathy TRAE (grade 3-4) 0.64 [0.01, 29.61]< 178%2 studies (2/-)58.9 %some concernnot evaluable moderatenon 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) 2.33 [1.26, 4.30]< 10%10 studies (10/-)0.3 %some concernlow moderatenon important-
Pruritus TRAE (grade 3-4) 1.09 [0.24, 4.83]< 10%6 studies (6/-)45.6 %some concernnot evaluable moderatenon important-
Pyrexia TRAE (grade 3-4) 0.66 [0.05, 8.61]< 10%2 studies (2/-)62.4 %some concernnot evaluable moderatenon important-
Rash TRAE (grade 3-4) 2.02 [0.97, 4.21]< 10%10 studies (10/-)3.1 %some concernlow moderatenon important-
Renal and urinary disorders TRAE (grade 3-4) 1.97 [0.07, 59.09]< 10%1 study (1/-)35.0 %NAnot evaluable non important-
Respiratory, thoracic and mediastinal disorders TRAE (grade 3-4) 12.07 [0.67, 217.19]< 10%1 study (1/-)4.7 %NAnot evaluable non important-
Sepsis TRAE (grade 3-4) 2.06 [0.19, 22.93]< 10%2 studies (2/-)27.9 %some concernnot evaluable moderatenon important-
Severe skin reaction TRAE (grade 3-4) 2.45 [0.73, 8.21]< 130%5 studies (5/-)7.3 %some concernnot evaluable moderatenon important-
Skin and subcutaneous tissue disorders TRAE (grade 3-4) 5.00 [0.58, 43.09]< 10%1 study (1/-)7.3 %NAnot evaluable non important-
Stomatitis TRAE (grade 3-4) 1.04 [0.27, 4.02]< 10%5 studies (5/-)47.6 %some concernnot evaluable moderatenon important-
Thrombocytopenia TRAE (grade 3-4) 0.44 [0.19, 1.01]< 174%8 studies (8/-)97.4 %some concernserious moderatenon important-
Thyroiditis TRAE (grade 3-4) 0.78 [0.08, 7.49]< 10%3 studies (3/-)58.6 %some concernnot evaluable moderatenon important-
Vomiting TRAE (grade 3-4) 1.00 [0.51, 1.94]< 15%9 studies (9/-)50.4 %some concernnot evaluable moderatenon important-

AE (grade 3-4) endpoints 00

hepatitis (Autoimmune) AE (grade 3-4) 3.10 [0.49, 19.80]< 10%3 studies (3/-)11.7 %some concernnot evaluable moderatenon important-
Abdominal pain AE (grade 3-4) 1.23 [0.24, 6.38]< 10%1 study (1/-)40.4 %NAnot evaluable non important-
Acute kidney injury AE (grade 3-4) 0.24 [0.01, 5.34]< 10%1 study (1/-)81.4 %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) 0.38 [0.08, 1.76]< 10%4 studies (4/-)89.0 %some concernnot evaluable moderatenon important-
Anaemia AE (grade 3-4) 0.39 [0.17, 0.87]< 192%7 studies (7/-)98.9 %some concernserious moderatenon important-
Arthralgia AE (grade 3-4) 2.12 [0.74, 6.09]< 10%4 studies (4/-)8.2 %lownot evaluable highnon important-
Asthenia AE (grade 3-4) 0.97 [0.60, 1.57]< 113%7 studies (7/-)55.0 %some concernnot evaluable moderatenon important-
Back pain AE (grade 3-4) 0.87 [0.25, 3.00]< 14%4 studies (4/-)58.8 %some concernnot evaluable moderatenon important-
Blood creatinine increased AE (grade 3-4) 1.04 [0.10, 10.25]< 10%2 studies (2/-)48.8 %some concernnot evaluable moderatenon important-
Colitis AE (grade 3-4) 2.18 [0.61, 7.72]< 10%2 studies (2/-)11.5 %lownot evaluable highnon important-
Constipation AE (grade 3-4) 1.24 [0.53, 2.89]< 10%7 studies (7/-)31.0 %lownot evaluable highnon important-
Cough AE (grade 3-4) 1.00 [0.31, 3.18]< 10%6 studies (6/-)50.1 %lownot evaluable highnon important-
Decreased appetite AE (grade 3-4) 1.40 [0.76, 2.56]< 10%7 studies (7/-)13.8 %some concernserious 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) 1.07 [0.51, 2.26]< 154%7 studies (7/-)42.5 %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) 1.41 [0.77, 2.60]< 128%7 studies (7/-)13.5 %lowserious highnon important-
Epistaxis AE (grade 3-4) 0.62 [0.06, 6.00]< 10%2 studies (2/-)65.8 %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.