An overview of Real-World Data infrastructure for cancer research

There is increasing interest in the opportunities offered by Real World Data (RWD) to provide evidence where clinical trial data does not exist, but access to appropriate data sources is frequently recognised as a barrier to RWD research. There has, however, been significant progress on facilitating RWD access in the last few years across a range of scales, from local hospital research databases, through regional care records and national repositories, to the impact of federated learning approaches on internationally collaborative studies. In this paper we use a series of case studies, principally from the UK, to illustrate how RWD can be accessed for research and healthcare improvement at each of these scales. For each example we will discuss infrastructure and governance requirements with the aim of encouraging further work in this space that will help to fill evidence gaps in oncology.