What Can We Learn About Treatment Sequencing In Oncology Using RWD?

Contributors: Waldemar Ockert : PhD, Director, DRG Global Real-World Evidence

Publish date: 04 Apr, 2018

Over the last two decades, the treatment paradigm for many cancer indications has been transformed beyond recognition. To fully appreciate the magnitude of this change, consider this: a patient diagnosed with multiple myeloma ("MM") in 1998 had comparatively few treatment options. Since then, the launches of Revlimid, Thalomid, Pomalyst, Kyprolis, Farydak, Empliciti, and Venclexta, to name a few, have revolutionized treatment options and changed the lives of thousands of patients being treated for MM worldwide.

The welcome diversification of treatment options led to growing uncertainty in the clinical community about the best options for a given patient, as clinical trial designs are variable, making a direct comparison of the efficacy and safety profiles of different treatment options virtually impossible. The absence of real-world data meant that the clinical community was reliant on static traditional research methods to assess the merits of a given treatment sequence while operating within a dynamic environment of rapidly evolving treatment paradigms. Thus, adoption of new therapies was slow and inconsistent among oncologists. Similarly, biopharmaceutical manufacturers faced the challenge of capturing critical intelligence over how products were to be used in the real world.

Since then, the availability of high-quality real-world data (RWD) has opened the door for insights on sequencing changes for both monotherapies and combination regimens over time. It has introduced an unprecedented level of precision and granularity - necessary to understand treatment sequencing dynamics in a highly competitive oncology disease market. By using electronic medical records (EMRs) and healthcare claims data, we now have a rare vantage on how products are actually used. Similarly, the application of RWD offers the possibility of providing additional lines of evidence to assess the outcomes profile and comparability across treatment options.

The insights from real-world evidence (RWE) in oncology can be startling indeed. An evaluation of RWD from multiple countries provides evidence suggesting that multiple myeloma and non-small cell lung cancer patients receive their therapies far less frequently and in substantially lower doses, on average, compared to clinical guidelines and product labels. Similarly, evidence also indicates that patients who receive targeted therapies have not had any companion diagnostic tests to ascertain that the products would be effective.

Over the coming decade, RWE will play an increasingly important role on a global scale as the requirements for the precision of insight into treatment sequencing, persistence, compliance, and outcomes of the clinical setting post-approval continue to rise, and as these insights become increasingly recognised in regulatory and payer decision-making processes.

The oncology insights provided in this blog are DRG's own, based on an evaluation of health data in Germany and Japan, sourced from DRG's trusted network of global health data providers.

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To learn more about DRG's international real-world evidence capabilities in oncology, visit our webpage or discuss your needs with our experts by contacting GlobalRWE@teamdrg.com.

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