A framework for living evidence synthesis in cancer: Living, interactive network meta-analysis for first-line treatment of metastatic renal cell carcinoma (mRCC).

Authors

null

Irbaz Bin Riaz

Mayo Clinic, Rochester, MN

Irbaz Bin Riaz , Huan He , Alexander J. Ryu , Rabbia Siddiqi , Syed Arsalan Ahmed Naqvi , Yuan Yao , Muhammad Husnain , Deepa Maheswari , Qurat Ul Ain Riaz Sipra , Victor Montori , Richard Wayne Joseph , Hongfang Liu , Zhen Wang , Vitaly Herasevich , Parminder Singh , Thai Huu Ho , Alan Haruo Bryce , Lance C. Pagliaro , M. Hassan Murad , Brian Addis Costello

Organizations

Mayo Clinic, Rochester, MN, Dow University of Health Sciences, Karachi, Pakistan, University of Miami/Sylvester Cancer Center, Miami, FL, BUMC, Tucson, AZ, Mayo Clinic Hospital, Jacksonville, FL, Mayo Clinic, Phoenix, AZ, Mayo Clinic Arizona, Scottsdale, AZ

Research Funding

No funding received
None.

Background: Systematic reviews are outdated quickly when the evidence is rapidly evolving as the process is laborious and there is little incentive for primary author team of an index SRMA to update the evidence. Consequently, there is an epidemic of redundant SRMAs performed by different teams—sometimes with conflicted results—for treatment of first line mRCC. Methods: We have created a living, interactive systematic review (LISR)and network meta-analysis(LINMA) for the treatment of first line mRCC using an Artificial intelligence (AI) assisted framework for evidence synthesis (Living, Interactive evidence synthesis framework) (LIvE). The framework is implemented in five-layered architecture (application layer, shared module layer, core service layer, middleware layer, and storage layer) which work together to automate the identification of new studies and analysis and semi-automate the screening and data extraction. Dynamic features such as interactive tables, figures and evidence maps are enabled using Python and JavaScript programming languages. Results: We have maintained a living, interactive evidence profile for the first line treatment mRCC since September 2019 (LIVING WEBSITE) . Living search strategy identifies new studies as they become available. As of October 13, 2020 LISR, includes data 14 clinical trials (PRISMA). Baseline characteristics are summarized in an interactive table (TABLE). Cabozantinib& Nivolumab (Cabo-Nivo) is the highest ranked drug for improving Overall Response (OR), Progression Free Survival (PFS) and Overall Survival (OS) whereas Ipilimumab in combination with Nivolumab (Ipi-Nivo) is highest ranked drug for achieving complete response (CR). Ipi-Nivo and Atezolizumab & Bevacizumab (Ate-Bev) ranked highest and Cabo-Nivo ranked lowest for treatment related Adverse events (TRAEs). Results of network meta-analysis are summarized as interactive tables and plots (NMA), summary of findings tables (MULTIPLE COMAPRISONS) and evidence maps (MAP). Conclusions: LISRs can potentially reduce redundancy, increase transparency, reproducibility, enable shared-decision making (at a guideline level, or in a patient-clinician dyad) and support living guidelines.

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Abstract Details

Meeting

2021 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session: Renal Cell Cancer

Track

Renal Cell Cancer

Sub Track

Therapeutics

Citation

J Clin Oncol 39, 2021 (suppl 6; abstr 335)

DOI

10.1200/JCO.2021.39.6_suppl.335

Abstract #

335

Poster Bd #

Online Only

Abstract Disclosures