Reality check: Real-world evidence to support therapeutic development in hematologic malignancies

The landscape for evidence generation in hematologic malignancies is rapidly evolving. While randomized controlled trials (RCTs) remain the gold standard in support of drug efficacy, approval and use, the supplemental use of real-world data (RWD), generated as part of routine healthcare delivery, and real-world evidence (RWE), the insights derived from RWD, in this setting has become increasingly common. There is a wide variety of sources of RWD, each with its own strengths and weaknesses that need to be considered when determining its appropriate use in RWE generation. RWD and RWE have historically been utilized in the post-approval setting to assess real-world application, efficacy, and safety of approved therapies. However, due to increasing awareness of the advantages of additional sources of information, RWE sourced from clinical data are being increasingly used to provide context for regulatory decision-making across several diseases including hematologic malignancies. Today, many commercial vendors offer fully aggregated, de-identified and standardized real-world clinical data. To maximize the potential of RWD and RWE, important considerations are needed to ensure patient privacy and to reduce the potential for biases and residual confounding. Continued collaboration among researchers, regulators and industry partners are needed to optimize evidence generation to ensure that new therapies reach patients as quickly and safely as possible.