ANTICIPATING FUTURE COMPARATORS IN POST-ICI NSCLC: A LIVING EVIDENCE APPROACH USING REAL-TIME AI-ASSISTED LIVING SYSTEMATIC LITERATURE REVIEW (REAL-SLR)
Author(s)
Stacy Grieve, PhD1, Anna Forsythe, MBA, MSc, PharmD1, Saro Sarkisian, MD, MHA2.
1Oncoscope, Miami, FL, USA, 2Frederick Health, Frederick, MD, USA.
1Oncoscope, Miami, FL, USA, 2Frederick Health, Frederick, MD, USA.
OBJECTIVES: The EU Joint Clinical Assessment (JCA) requires current, robust comparator evidence to support clinical effectiveness assessments. In advanced Non-Small-Cell Lung Cancer (NSCLC), treatment options following progression on immune checkpoint inhibitors (ICIs) remain limited; however, rapid expansion of novel therapeutic classes is creating an increasingly complex comparator landscape. This study uses the REAL-SLR database to identify emerging comparator classes and inform evidence-generation and JCA planning in post-ICI NSCLC.
METHODS: A PRISMA-compliant REAL-SLR was conducted using continuously updated protocol-driven searches for advanced NSCLC. Interventional studies in metastatic NSCLC previously treated with ICIs were identified from publications and major conference abstracts and mapped according to clinical stage, treatment pathway, intervention category, and subgroup characteristics. US/EU regulatory status, guideline recommendations, and HTA-relevant treatment positioning supplemented evidence mapping. Studies were limited to primary publications from 2022 onward.
RESULTS: As of June 17, 2026, the REAL-SLR identified 126 studies evaluating interventions following prior ICI exposure in metastatic NSCLC after excluding approved/recommended therapies and failed studies. Combination regimens incorporating ICIs with targeted agents and/or chemotherapy represented the largest category (55/126, 44%), with 40% evaluating novel ICIs not currently approved/recommended in the US/EU. Emerging intervention classes included antibody-drug conjugates (ADCs;15%), bispecific/trispecific antibodies (8%), and cell/gene therapies (8%), with 26%, 10%, 50% of studies in phase 2, respectively. Most ADC and bispecific programs were designed to enhance or restore anti-tumor immune responses. Among ADC studies, 37% targeted immune checkpoint proteins, while 60% of bispecific studies evaluated agents with both binding domains interacting with the immune system.
CONCLUSIONS: The REAL-SLR database identified emerging treatment classes likely to become future comparators in post-ICI NSCLC. Continuous evidence monitoring may support earlier identification of comparator shifts, reduce evidence-generation risk, and improve preparedness for JCA, HTA, and reimbursement decision-making in rapidly evolving oncology indications.
METHODS: A PRISMA-compliant REAL-SLR was conducted using continuously updated protocol-driven searches for advanced NSCLC. Interventional studies in metastatic NSCLC previously treated with ICIs were identified from publications and major conference abstracts and mapped according to clinical stage, treatment pathway, intervention category, and subgroup characteristics. US/EU regulatory status, guideline recommendations, and HTA-relevant treatment positioning supplemented evidence mapping. Studies were limited to primary publications from 2022 onward.
RESULTS: As of June 17, 2026, the REAL-SLR identified 126 studies evaluating interventions following prior ICI exposure in metastatic NSCLC after excluding approved/recommended therapies and failed studies. Combination regimens incorporating ICIs with targeted agents and/or chemotherapy represented the largest category (55/126, 44%), with 40% evaluating novel ICIs not currently approved/recommended in the US/EU. Emerging intervention classes included antibody-drug conjugates (ADCs;15%), bispecific/trispecific antibodies (8%), and cell/gene therapies (8%), with 26%, 10%, 50% of studies in phase 2, respectively. Most ADC and bispecific programs were designed to enhance or restore anti-tumor immune responses. Among ADC studies, 37% targeted immune checkpoint proteins, while 60% of bispecific studies evaluated agents with both binding domains interacting with the immune system.
CONCLUSIONS: The REAL-SLR database identified emerging treatment classes likely to become future comparators in post-ICI NSCLC. Continuous evidence monitoring may support earlier identification of comparator shifts, reduce evidence-generation risk, and improve preparedness for JCA, HTA, and reimbursement decision-making in rapidly evolving oncology indications.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
SA49
Topic
Study Approaches
Topic Subcategory
Literature Review & Synthesis
Disease
Oncology