COMPREHENSIVE REAL-TIME AI-ASSISTED LIVING SYSTEMATIC LITERATURE REVIEW (REAL-SLR) OUTPERFORM CUSTOM REVIEWS FOR STRATEGIC HEALTH TECHNOLOGY ASSESSMENT (HTA) AND MARKET ACCESS (MA) PLANNING: AN ADVANCED METASTATIC BREAST CANCER (MBC) EXAMPLE
Author(s)
Stacy Grieve, PhD1, Arup Pramanik, MSc, MD, MBA2, Rozee Liu, MSc1, Anna Forsythe, MBA, MSc, PharmD1;
1Oncoscope-AI, Miami, FL, USA, 2Boehringer Ingelheim, Sharon, MA, USA
1Oncoscope-AI, Miami, FL, USA, 2Boehringer Ingelheim, Sharon, MA, USA
OBJECTIVES: SLRs underpin HTA and MA decisions; traditional custom SLRs are designed around narrow, question-specific scopes. Within dynamic oncology landscapes, evolving evidence dictates the need for scope modifications during HTA negotiations. This study demonstrates the strategic limitations of custom SLRs and the advantages of a comprehensive REAL-SLR approach using an antibody-drug conjugate (ADC) development scenario in mBC.
METHODS: A comprehensive REAL-SLR was established using a broad, PRISMA-aligned, protocol-driven search strategy capturing the full mBC evidence-base. All records were retained and updated daily. Strategic questions were addressed through real-time refinement of Population-Intervention-Comparator-Outcome (PICO) criteria, with automated updates to PRISMA flow diagrams and HTA-compliant SLR outputs. Timelines and workflow implications were compared with a custom SLR.
RESULTS: As of January 5, 2026, the REAL-SLR contained 919 BC studies. Filtering for ADCs identified 119 studies, including 94 in mBC. Further narrowing to previously-treated HR+/HER2-negative disease yielded 36 studies, 16 HER2-low/ultra-low studies, including 5 randomized controlled trials (RCTs): 2 reported statistically-significant overall survival; 3 included quality-of-life outcomes. Generating an HTA-ready report following multiple scope refinements required 3 minutes. In contrast, a custom SLR addressing the ADC-comparator landscape in this population would require ≥3 months. Requests by HTA bodies for expanded comparators or alternative populations are likely; within the last 6 months in 2025, 37 new mBC studies of ADCs were published, including 2 RCTS reporting positive outcomes for novel ADCs not previously captured. Such requests require changes to search strategy and PICOs, increasing time for custom SLR updates and highlighting the risk of evidence obsolescence.
CONCLUSIONS: Custom SLRs introduce structural delays and strategic risk. A REAL-SLR offers timely updates and adjustable parameters to keep-up with HTA requirements without losing methodological rigor. This approach supports faster, more resilient, and negotiation-ready market access and HTA decision making in rapidly changing oncology settings.
METHODS: A comprehensive REAL-SLR was established using a broad, PRISMA-aligned, protocol-driven search strategy capturing the full mBC evidence-base. All records were retained and updated daily. Strategic questions were addressed through real-time refinement of Population-Intervention-Comparator-Outcome (PICO) criteria, with automated updates to PRISMA flow diagrams and HTA-compliant SLR outputs. Timelines and workflow implications were compared with a custom SLR.
RESULTS: As of January 5, 2026, the REAL-SLR contained 919 BC studies. Filtering for ADCs identified 119 studies, including 94 in mBC. Further narrowing to previously-treated HR+/HER2-negative disease yielded 36 studies, 16 HER2-low/ultra-low studies, including 5 randomized controlled trials (RCTs): 2 reported statistically-significant overall survival; 3 included quality-of-life outcomes. Generating an HTA-ready report following multiple scope refinements required 3 minutes. In contrast, a custom SLR addressing the ADC-comparator landscape in this population would require ≥3 months. Requests by HTA bodies for expanded comparators or alternative populations are likely; within the last 6 months in 2025, 37 new mBC studies of ADCs were published, including 2 RCTS reporting positive outcomes for novel ADCs not previously captured. Such requests require changes to search strategy and PICOs, increasing time for custom SLR updates and highlighting the risk of evidence obsolescence.
CONCLUSIONS: Custom SLRs introduce structural delays and strategic risk. A REAL-SLR offers timely updates and adjustable parameters to keep-up with HTA requirements without losing methodological rigor. This approach supports faster, more resilient, and negotiation-ready market access and HTA decision making in rapidly changing oncology settings.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HTA8
Topic
Health Technology Assessment
Topic Subcategory
Systems & Structure
Disease
SDC: Oncology