Crossing borders: the need for empirical evidence of real-world evidence transportability in oncology.

WHAT IS THIS ARTICLE ABOUT?: This article discusses the challenges of using non local real-world evidence (RWE) in health technology assessments (HTA) when local data are unavailable, insufficient, or inappropriate. HTA organizations often prefer data collected locally or regionally, but the lack of suitable data in many markets has increased interest in understanding data 'transportability' - whether data from one country or population can be used to predict outcomes in another. Established in 2024, the Flatiron Fostering Oncology RWE Use Cases and Methods (FORUM) research consortium is exploring when and how non-local RWE can be effectively applied, with initial work focused on lung cancer, breast cancer and multiple myeloma. WHAT DOES THE EVIDENCE SUGGEST SO FAR?: Initial studies suggest RWE from the US could predict outcomes in other countries with proper adjustment for population and treatment differences. Recent research in advanced non-small cell lung cancer demonstrated that adjusted US data provided comparable survival to real observed outcomes in Canada and the UK. This limited evidence base indicates that non-local RWE can help inform decision-making when local data is unavailable. WHAT STUDIES ARE NEEDED NEXT?: The FORUM consortium is expanding research to other cancer types and countries to better understand RWE transportability. Future studies will focus on comparing outcomes across diverse healthcare systems, identifying key variables for adjustment and developing guidelines for when and how non-local data can be used. These efforts aim to create a framework for the use of global RWE in oncology HTA decision-making.