REAL-TIME AI-ASSISTED LIVING SYSTEMATIC LITERATURE REVIEW (REAL-SLR) CAPTURES A 2025 STANDARD-OF-CARE (SOC) SHIFT DRIVEN BY ANTIBODY-DRUG CONJUGATES (ADCS) IN UROTHELIAL CARCINOMA (UC): IMPLICATIONS FOR HEALTH TECHNOLOGY ASSESSMENTS (HTAS)
Author(s)
Rhiannon Campden, PhD1, Ellen Kasireddy, MSc1, 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: HTAs relies on timely, comprehensive synthesis of clinical evidence aligned with evolving standards of care. In UC, the rapid emergence of ADCs and combination regimens culminated in a first-line SOC shift in 2025, challenging traditional static SLRs that underpin HTA and reimbursement decisions. This study evaluates the capability of REAL-SLR to identify paradigm-shifting evidence in UC as it emerges, using a case study on ADC.
METHODS: The UC REAL-SLR is a daily-updated, living SLR library applying standardized, protocol-driven searches with AI-assistance to support deduplication, screening, study mapping, and extraction following PRISMA/Cochrane guidelines and the Population, Intervention/Comparator, Outcomes, and Study design (PICOS) framework. Regulatory approvals and clinical guideline updates are systematically linked to individual studies to support HTA-relevant interpretation. Identification of SOC shifts was assessed by reviewing ADC-related publications, regulatory decisions, and guideline updates incorporated during the 2025 calendar year.
RESULTS: In 2025, the UC REAL-SLR screened 17,114 records and added 635 new abstracts, including 50 from ASCO-GU, 53 from ASCO, and 20 from ESMO with abstracts added upon publication and immediately available via an interactive platform. Among 31 ADC studies identified, 14 were published in 2025, including pivotal evidence supporting enfortumab-vedotin+pembrolizumab in first-line metastatic UC, marking a clear SOC transition. The REAL-SLR also captured evolving guideline-recommended ADCs (e.g., trastuzumab-deruxtecan) and changing regulatory status (e.g., sacituzumab-govitecan), as well as emerging agents in development such as disitamab-vedotin and datopotamab-deruxtecan. REAL-SLR integrated clinical guidelines and regulatory approvals, enabling real-time visibility into SOC shifts and differences in the timing of evidence incorporation into recommendations.
CONCLUSIONS: REAL-SLR enables HTA stakeholders to detect and contextualize SOC changes as they occur, rather than retrospectively. In UC, where ADC-driven innovation altered first-line treatment in 2025, REAL-SLR provides HTA-ready evidence foundation that reduces rework, improves transparency, and supports timely reimbursement and access decisions in rapidly evolving oncology landscapes.
METHODS: The UC REAL-SLR is a daily-updated, living SLR library applying standardized, protocol-driven searches with AI-assistance to support deduplication, screening, study mapping, and extraction following PRISMA/Cochrane guidelines and the Population, Intervention/Comparator, Outcomes, and Study design (PICOS) framework. Regulatory approvals and clinical guideline updates are systematically linked to individual studies to support HTA-relevant interpretation. Identification of SOC shifts was assessed by reviewing ADC-related publications, regulatory decisions, and guideline updates incorporated during the 2025 calendar year.
RESULTS: In 2025, the UC REAL-SLR screened 17,114 records and added 635 new abstracts, including 50 from ASCO-GU, 53 from ASCO, and 20 from ESMO with abstracts added upon publication and immediately available via an interactive platform. Among 31 ADC studies identified, 14 were published in 2025, including pivotal evidence supporting enfortumab-vedotin+pembrolizumab in first-line metastatic UC, marking a clear SOC transition. The REAL-SLR also captured evolving guideline-recommended ADCs (e.g., trastuzumab-deruxtecan) and changing regulatory status (e.g., sacituzumab-govitecan), as well as emerging agents in development such as disitamab-vedotin and datopotamab-deruxtecan. REAL-SLR integrated clinical guidelines and regulatory approvals, enabling real-time visibility into SOC shifts and differences in the timing of evidence incorporation into recommendations.
CONCLUSIONS: REAL-SLR enables HTA stakeholders to detect and contextualize SOC changes as they occur, rather than retrospectively. In UC, where ADC-driven innovation altered first-line treatment in 2025, REAL-SLR provides HTA-ready evidence foundation that reduces rework, improves transparency, and supports timely reimbursement and access decisions in rapidly evolving oncology landscapes.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HTA78
Topic
Health Technology Assessment
Topic Subcategory
Systems & Structure
Disease
SDC: Oncology