A Narrative Review of the Strengths and Limitations of Real-World Evidence in Comparison to Randomized Clinical Trials: What Are the Opportunities in Thoracic Oncology for Real-World Evidence to Shine?

Randomized clinical trials are considered the gold standard for the evaluation of new interventions and therapies. The results from randomized clinical trials are highly influential in treatment decision-making and decisions about the implementation of new therapeutic options within the field of oncology. This article describes a narrative review of the literature to further explore the strengths and limitations of real-world evidence in comparison to randomized clinical trials and provides a commentary on opportunities for real-world evidence in thoracic malignancies. However, randomized trials often exclude oncology patients with poorer functional status or comorbidities which are routinely considered for treatment in real-world practice. Real-world data may complement existing data from randomized clinical trials and play an important role in evaluating patterns and outcomes of care, informing everyday oncology practice. While real-world data is increasingly reported in the medical literature, strengths and limitations exist which can also limit their applicability. More work is needed to standardize methodologies for real-world studies.