RAPIDLY EVOLVING TREATMENT LANDSCAPE IN MULTIPLE MYELOMA - LEVERAGING A LIVING SYSTEMATIC LITERATURE REVIEW (SLR)
Author(s)
Mihaela Musat, PhD1, Jessicca Rege, PhD1, Saro Sarkisian, MD, MHA2, Rozee Liu, MSc1, Anna Forsythe, MBA, MSc, PharmD1;
1Oncoscope-AI, Miami, FL, USA, 2Frederick Health, Frederick, MD, USA
1Oncoscope-AI, Miami, FL, USA, 2Frederick Health, Frederick, MD, USA
OBJECTIVES: SLRs are critical to healthcare stakeholder decision making but require large amount of time and resource investment while quickly becoming outdated. Living SLRs address these challenges by continuously updating the evidence. We aimed to create a living SLR library and analyze the evolving landscape of therapies, outcomes and trial approaches in multiple myeloma.
METHODS: We created a daily-updated REal-time AI-assisted Living SLR (REAL-SLR) in multiple myeloma, compliant with PRISMA and Cochrane guidelines, using the Population, Intervention/Comparators, Outcomes, and Study design (PI/COS) framework. Clinical trials published in English were identified in PubMed and relevant conference proceedings. Evidence was stratified by treatment pathways and interventions, outcomes, and subgroups categories.
RESULTS: As of January 5, 2026, REAL-SLR included 709 studies in multiple myeloma: 300 in newly diagnosed (NDMM), 410 in relapsed/refractory (RRMM), and 20 in smoldering myeloma populations. Minimal residual disease (MRD)-related outcomes were included in 203 studies, 70% of which were published in 2024-2025 alone. MRD-guided treatment strategies received increased attention, with 17/21 of the MRD-guided trials published in 2024-2025. Temporal trends of interventions in NDMM showed a growing interest towards quadruplet combinations, antibody-drug conjugates (ADCs), bispecific/trispecific antibodies, E3 ligase modulators, and CAR-Ts. Similarly, therapies generally reserved for heavily pre-treated patients such as CAR-Ts, bispecific/trispecific antibodies, and ADCs, have been recently investigated in earlier lines of therapy for RRMM. As CAR-Ts and B-cell maturation antigen-targeted therapies entered the RRMM guidelines, recent trials have documented patients with prior exposure to these agents (59 studies) and included them as subgroups of interest.
CONCLUSIONS: The daily maintenance of the REAL-SLR allowed real-time analysis of trends in reported outcomes, intervention categories, and subgroups of interest in multiple myeloma. Comprehensiveness, evidence stratification, and daily updating of the REAL-SLR provide valuable insights for decision-making, in a faster and more easily accessible way compared to static ad-hoc SLRs.
METHODS: We created a daily-updated REal-time AI-assisted Living SLR (REAL-SLR) in multiple myeloma, compliant with PRISMA and Cochrane guidelines, using the Population, Intervention/Comparators, Outcomes, and Study design (PI/COS) framework. Clinical trials published in English were identified in PubMed and relevant conference proceedings. Evidence was stratified by treatment pathways and interventions, outcomes, and subgroups categories.
RESULTS: As of January 5, 2026, REAL-SLR included 709 studies in multiple myeloma: 300 in newly diagnosed (NDMM), 410 in relapsed/refractory (RRMM), and 20 in smoldering myeloma populations. Minimal residual disease (MRD)-related outcomes were included in 203 studies, 70% of which were published in 2024-2025 alone. MRD-guided treatment strategies received increased attention, with 17/21 of the MRD-guided trials published in 2024-2025. Temporal trends of interventions in NDMM showed a growing interest towards quadruplet combinations, antibody-drug conjugates (ADCs), bispecific/trispecific antibodies, E3 ligase modulators, and CAR-Ts. Similarly, therapies generally reserved for heavily pre-treated patients such as CAR-Ts, bispecific/trispecific antibodies, and ADCs, have been recently investigated in earlier lines of therapy for RRMM. As CAR-Ts and B-cell maturation antigen-targeted therapies entered the RRMM guidelines, recent trials have documented patients with prior exposure to these agents (59 studies) and included them as subgroups of interest.
CONCLUSIONS: The daily maintenance of the REAL-SLR allowed real-time analysis of trends in reported outcomes, intervention categories, and subgroups of interest in multiple myeloma. Comprehensiveness, evidence stratification, and daily updating of the REAL-SLR provide valuable insights for decision-making, in a faster and more easily accessible way compared to static ad-hoc SLRs.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HTA7
Topic
Health Technology Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology