Presentation (CTI)

OBJECTIVES: HTA bodies increasingly require timely, transparent, and comprehensive evidence packages aligned to evolving standards of care. Traditional de novo SLRs are resource-intensive, slow to update, and often misaligned with the dynamic evidence needs of HTA processes. This study evaluates the value of a REAL-SLR as an enabling infrastructure for HTA readiness, using BCa as a case study.
METHODS: A BCa REAL-SLR was developed using PROSPERO-published protocol compliant with PRISMA and Cochrane guidelines, and using the Population, Intervention/Comparator, Outcomes, and Study design (PICOS) framework with AI review/extraction and 100% human quality assurance. Workflows, staffing requirements, and timelines for HTA-relevant evidence access via REAL-SLR were compared with those of a traditional manual SLR. Evidence growth in BCa REAL-SLR was assessed based on abstracts added during the 2025 calendar year.
RESULTS: During 2025, the BCa REAL-SLR screened 21,893 records and incorporated 1,892 new publications, including 33 from ESMO Breast, 95 from ASCO, 68 from ESMO, and 33 from SABCS, with 5-10-day turnaround following major congresses. Achieving equivalent coverage through a manual SLR would require >16 weeks of effort from two junior and one senior researchers, delaying HTA readiness. REAL-SLR reduced time to HTA-relevant evidence access to on-demand, delivering >90% time savings through daily searches, automated deduplication, and immediate availability of structured, PICOS-aligned data. The REAL-SLR captured multiple practice-changing BCa updates in 2025 relevant to HTA evaluations, including first-line trastuzumab deruxtecan plus pertuzumab for HER2-positive metastatic BCa, adjuvant trastuzumab deruxtecan for HER2-positive disease, first-line sacituzumab govitecan or datopotamab deruxtecan for triple-negative metastatic BCa, and adjuvant giredestrant for HR+/HER2-negative BCa.
CONCLUSIONS: REAL-SLR enables a shift from episodic SLRs to a continuously maintained HTA evidence foundation. By supporting real-time incorporation of emerging data and rapid alignment to HTA requirements, REAL-SLR improves preparedness, reduces rework, and enhances transparency for oncology HTA decision making.