PROJECT SUMMARY
The rationale for a more detailed understanding of the safety and efficacy of new therapies for cancer is
compelling. While cancer therapies have always had an element of risk to both well-being and to quality of
life, much has changed in therapeutics in the past ten years. Most important, a greater understanding of the
biological characteristics of cancer has led to more nuanced definitions of populations that may benefit than
were previously possible. With greater use of genomics and resulting specification of precise molecular
characteristics of target cancers, and through (though early) markers of sensitivity and resistance to
immunotherapeutics, both the indications and the use of novel therapeutics is resulting in higher response
rates and more favorable outcomes, at least as judged by progress in clinical trials. Parallel advances in
medical care and the universal adoption of an electronic health record (EHR), coupled with advances in quality
of life (QOL) and other patient-reported outcomes (PROs), have made possible a deeper analysis of the
effects and the risks of new therapies as their use is diffused throughout the medical system. Following upon
several guidances to the effect of encouraging and defining the use of real-world data (RWD) to provide real-
world evidence (RWE), this funding mechanism is designed to foster approaches to capture, organize, and
analyze RWD to produce RWE. We propose herein a many-pronged approach that brings together two
strategies: 1) a reimagining of how acquisition of robust, representative, and accurate RWD could be obtained
from existing clinical trials' processes; 2) how an effective RWD approach could generate robust RWE in rare
and less common tumors alike. To assist in this goal, we have developed a collaboration with Optum Life
Sciences, both to help recruit diverse populations with specific molecular profiles, and to characterize
populations with extended databases in various domains. Our Aims are first, to harmonize Phase III and
Phase IV evaluations of new therapies to obtain real-world evidence of the standard therapy in Phase III, and
subsequently of the successful therapy in Phase IV; second, using this cooperative group model, to establish
feasibility of a real-world data Phase IV approach to the evaluation of new therapies for rare tumors. We
expect that by developing these approaches to rigorous data collection in a short timeframe, we will be
complementary to informatics approaches to data collection developed in parallel and provide for them a
robust database for comparative analyses.