Recommendations for Comparing Therapeutic Sequences for Patients with Breast, Kidney, and Other Advanced and Metastatic Cancers (Aug 2015)

This EGD provides recommendations to use real-world data sources in studies to compare sequences of therapies in areas of advanced and metastatic cancer where a range of therapeutic options exist but evidence is lacking on the optimal choices for sequential or combination therapy. The focus is on settings where the expected outcome of therapy is not a cure since patient decisions in these settings often involve negotiation of more complex tradeoffs than in curative settings—tradeoffs in which factors other than overall survival may have heightened importance. Metastatic breast cancer and renal cell carcinoma served as example disease areas for developing this EGD, but this approach may be relevant for other incurable cancers as well. The EGD recommends the analysis of novel outcomes and suggests ways that existing data sources should be enhanced for more robust research studies of this type.