Real-World Evidence and Randomized Studies in the Precision Oncology Era: The Right Balance | JCO Precision Oncology

Real-World Evidence and Randomized Studies in the Precision Oncology Era: The Right Balance | JCO Precision Oncology

Real-World Evidence and Randomized Studies in the Precision Oncology Era: The Right Balance

Bishal Gyawali, Sandeep Parsad, Bruce A. Feinberg, and Chadi NabhanShow More

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Randomized clinical trials (RCTs) are the gold standard for rational therapeutics in evidence-based medicine.1 Although variable, the cost of conducting an RCT can be as high as $1 billion,1 putting into question their feasibility for every health care intervention. Also, the broader application of RCT outcomes has been subject to scrutiny, considering the inherent selection bias. Less than 5% of adult patients with cancer participate in clinical trials, and those who do are younger, healthier, and less diverse than their real-world counterparts.2 Today, RCTs remain the gold standard despite changing practice patterns; however, because of their limitations, coupled with unmet health care needs, a reassessment of whether this traditional approach should be required for low-risk interventions, particularly in cancer, is warranted.