Real-World Evidence in Cancer Program

Most colorectal cancer (CRC) diagnoses occur in older adults—many of whom are taking multiple medicines to treat other comorbidities at the time of diagnosis. Patients with comorbidities and complex medicine profiles present challenges to the safe and effective delivery of cancer therapy. At the same time, Australia has the highest incidence of CRC in younger people (<50 years) in the world. Younger people with CRC often receive more intensive treatment but may not realise benefits from that treatment. Additionally, CRC treatments may have life-long impacts—such as increased risk of serious cardiovascular events—that can be exacerbated by multiple medicine use long after CRC treatment ends. This project investigates the treatment and outcomes of CRC in Australia.

EVEREST-C builds on global advances in the use of real world data – reported directly from patients (e.g., patient reported outcomes [PROs]) or generated during routine clinical care – to generate knowledge that addresses evidence gaps in the real-world effectiveness of cancer medicines. By integrating these insights into the process of decision-making, EVEREST-C aims to strengthen HTA decision-making, ensuring it is both timely and grounded in the lived experience of patients.

This project aims to improve care and outcomes for people with ovarian cancer by studying how new tests and treatments are used in real life, and how well they work.

Aim 1 focuses on understanding how newly funded, targeted treatments (such as PARP inhibitors) are being used across the population. By analysing linked health data, the study will look at who receives these treatments, how long patients stay on them, and how they impact survival. This information will help guide doctors and policymakers to make better decisions about cancer treatment and funding.

Aim 2 looks at molecular testing, which is used to identify patients who may benefit from these newer therapies. The research will investigate why some test results are unclear and identify ways to improve how samples are collected and tested. The goal is to ensure all patients have the best chance of accessing appropriate treatments.

Across both aims, the project involves collaboration with clinical experts, use of large-scale health data, and input from consumer representatives.

This PhD project aims to generate real-world evidence (RWE) to better understand patterns of care and patient outcomes in rare cancers, with a particular focus on biliary tract cancer (BTC). The research will begin with a comprehensive literature review, followed by a modified Delphi process to establish consensus-driven quality-of-care indicators for BTC, intended to inform clinical practice and health policy. Using linked healthcare and clinical datasets, the project will then examine real-world patterns of systemic treatment in BTC and assess these against the defined quality-of-care indicators. It will also quantify patient outcomes overall and in relation to the care received.

By identifying treatment pathways and gaps in care, this research will provide evidence to support improvements in clinical practice and guide future research. It is also intended to serve as a model for generating real-world evidence in other rare cancers.

Immunotherapies have improved the prognosis for many cancer patients but their benefits are tempered by immune-related adverse events. This project establishes the first Australian cohort of patients using immunotherapy in the real-world clinic and investigates how patient factors and prescribing patterns intersect and affect the health outcomes of patients using immunotherapy so that the benefits of these medicines can be maximised and the harms minimised.

This International consortium funded by the International Agency for Research on Cancer harmonizes data from 30 sources, including prospective cohort studies, cancer registries, medication dispensing or prescription records, and electronic health records across the North America, Europe, and Australia. Professor Sallie Pearson is the Australian lead.