Oncology innovation is moving faster than ever. Targeted therapies, immunotherapies, and precision medicine are redefining what is possible for patients. But as progress accelerates, a critical gap is becoming more visible. Groundbreaking treatments are being developed in controlled settings, yet the sector is still working to understand how those therapies perform amid the complexity of real-world care.
Clinical trials remain the foundation for bringing new therapies to market. They establish safety and efficacy under carefully defined conditions. But in practice, clinicians are making decisions for patients who rarely resemble trial populations. They may be older, have multiple comorbidities, receive care across fragmented settings, or face socioeconomic factors that influence outcomes in ways trials are not designed to capture.
For clinicians, researchers, payers, and regulators, one of the most persistent challenges is understanding what happens after a therapy leaves the trial environment. Clinicians and researchers are often left piecing together how treatments are to be used in routine care, including how to sequence therapies in everyday practice for patients who fall outside typical trial populations. They are also working to understand how patients with more complex profiles are responding and where outcomes diverge from what was observed in trials. These are the questions that increasingly shape real-world decision-making, and they cannot be answered by trials alone.
Real-world evidence helps address this gap by linking what is demonstrated in trials with what actually happens in practice. When built from clinically rich, longitudinal data, it provides visibility into how therapies perform across broader, more diverse patient populations and over longer time horizons than most trials capture.
That visibility is especially important in oncology, where differences in tumor biology, biomarker expression, prior therapies, and patient comorbidities can all influence how a patient responds to treatment. Two patients with the same diagnosis may follow very different clinical paths depending on these factors, making it difficult to rely on trial data alone when making treatment decisions.
When built from clinically rich, longitudinal data, real-world evidence provides a way to link what is demonstrated in trials with what actually happens in practice. It offers visibility into how therapies perform across broader, more diverse patient populations and over longer time horizons than most trials capture.
For clinicians, this translates into more informed treatment strategies, particularly around sequencing and identifying which patients are most likely to benefit from a given therapy. Without this level of insight, decisions are often made through extrapolation of trial data and/or anecdotal experience.
For health systems and payers, real-world evidence helps build a more complete picture of value and outcomes, supporting decisions around access and reimbursement. In its absence, value assessments may be incomplete or worse, inaccurate.
For researchers, it offers a feedback loop that can refine trial design and highlight persistent gaps in care. Without these insights, opportunities to address unmet needs or improve study design may be missed.
For regulators, real-world evidence offers proof that the efficacy and safety signals seen in clinical trials are applicable to an unselected patient population.
The impact of real-world evidence, however, depends heavily on the quality of the data behind it. Oncology care generates highly complex, longitudinal information, from staging and biomarkers to treatment histories and outcomes. Capturing and structuring this data in a clinically meaningful way requires intentional data curation, alignment to standardized frameworks, and ongoing validation to ensure accuracy and completeness.
Efforts to integrate data from electronic health records, registries, and other sources, while maintaining clinical context, are essential to making real-world evidence actionable. Without that level of rigor, the insights generated may fall short of what clinicians, researchers, and decision-makers need.
There is also a patient impact that should not be overlooked. When evidence reflects real clinical experiences, it becomes a tool for identifying disparities in care, surfacing differences in outcomes across populations, and supporting more tailored approaches to treatment. In that sense, real-world evidence is not just about data, but about ensuring that innovation translates into meaningful benefits for a broader range of patients.
Looking ahead, the role of real-world evidence will continue to expand as oncology becomes more complex. Organizations that can generate and apply high-quality, clinically grounded evidence will be better positioned to close the gap between what is proven in trials and what is achieved in practice.
Real-world evidence does not replace clinical trials, but it extends their value. By connecting innovation with real-world outcomes, it can help ensure that advances in oncology translate into more informed decisions and better patient care.
Photo: elenabs, Getty Images
C.K. Wang is the General Manager of Oncology and Chief Medical Officer at Verana Health where he oversees the oncology division and serves as the clinical lead for the company. C.K. joined Verana Health through a merger with COTA where he served as the Chief Medical Officer for six years and, under his tenure as Chief Executive Officer, finalized COTA’s merger with Verana Health.
During his time at COTA, C.K. launched the company’s research services and helped establish COTA as the premier hematologic oncology real-world solutions provider. Prior to COTA, C.K. served in numerous leadership roles within IBM Watson Health’s Oncology and Genomics division supporting clients and partners on a global basis. Previous to IBM Watson Health, C.K. spent 12+ years in clinical practice where he focused on establishing oncology practices and cancer programs.
C.K. holds a B.A. in Biology from Washington University in St. Louis and received his medical degree from the University of Texas Medical School in San Antonio. He completed his internal medicine residency at the University Hospitals of Cleveland/ Case Western Reserve University and his hematology and oncology fellowship at the University of Texas Southwestern Medical Center. He is board certified in medical oncology.
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