BMJOPEN2014006321F5: Forest plot comparing the severe side effects (grades ≥3) between the tumour vaccine group and control group. Some serious adverse effects occurred equally in both groups. The random effects meta-analysis model was used in this analysis.

Mentions: Treatment-related adverse effects (AEs) (any grades and grades ≥3) and efficacy for patients with advanced NSCLC were evaluated in the 11 collected studies. The patients in the vaccine group observed fewer obvious side effects compared with the corresponding control group, such as nausea and vomiting, thrombocytopaenia and injection site reaction (p≤0.05). Patients receiving tumour vaccine therapy experienced six other AEs, which occurred equally in the control group, including anaemia, leucopaenia, body pain, fatigue, fever, headache, anorexia, arthralgia and dyspnoea (p>0.05; figure 4). Furthermore, we separately considered the adverse effects of grades ≥3. The pooled analysis showed that the patients who received vaccine treatment experienced a few severe adverse effects (grades ≥3), including nausea and vomiting (p=0.57), body pain (p=0.19) and anorexia (p=0.27), which did not generate statistical difference compared with the corresponding control group (figure 5). Heterogeneity was observed; the random effects models were used for side effect and serious AE analysis.