Defining the role of pragmatic clinical trials in cancer clinical research: Outcomes of a collaborative workshop hosted by the European Organisation for Research and Treatment of Cancer Journal Article


Authors: Cardoso Borges, F.; van der Graaf, W. T. A.; Saesen, R.; Aebi, S.; Amariutei, A. E.; Bekelman, J.; Gorlia, T.; Hulstaert, F.; Huys, I.; Kluetz, P.; Morris, M. J.; Patil, V.; Prindiville, S. A.; Schilsky, R. L.; Thomson, A.; Treweek, S.; Weller, M.; Zuidgeest, M.; Retel, V.; Lacombe, D.
Article Title: Defining the role of pragmatic clinical trials in cancer clinical research: Outcomes of a collaborative workshop hosted by the European Organisation for Research and Treatment of Cancer
Abstract: Explanatory clinical trials, which focus on evaluating therapeutic efficacy under ideal circumstances, are crucial for learning about new therapeutic interventions; however, they also exhibit shortcomings. These include non-representative populations and frequent use of intermediate endpoints, leading to uncertainty about the applicability of study results to patients in the real-world. Moreover, these trials often do not address all clinically meaningful questions, highlighting the need for optimisation within the oncology research framework. Refinements can be partly achieved by incorporating more pragmatic elements into cancer clinical trials. At a virtual European Organisation for Research and Treatment of Cancer workshop, key stakeholders convened to discuss the methodological characteristics and value of pragmatic trials, which focus on evaluating effectiveness in routine clinical practice, and their capacity to address the efficacy–effectiveness gap. This Policy Review outlines and discusses some of the views and perspectives expressed on the role of pragmatic trials in the current framework and their ability to inform decision making, and the recommended priorities for enhancing pragmatism in cancer clinical research. © 2025 Elsevier Ltd
Keywords: review; clinical trials as topic; research design; methodology; clinical practice; neoplasm; neoplasms; biomedical research; europe; medical research; clinical research; drug therapy; therapy; pharmacology; randomized controlled trial (topic); clinical trial (topic); workshop; procedures; humans; human; malignant neoplasm; pragmatic trial; pragmatic clinical trials as topic; pragmatism
Journal Title: Lancet Oncology
Volume: 26
Issue: 5
ISSN: 1470-2045
Publisher: Elsevier Science, Inc.  
Date Published: 2025-05-01
Start Page: e253
End Page: e263
Language: English
DOI: 10.1016/s1470-2045(24)00756-3
PUBMED: 40318657
PROVIDER: scopus
DOI/URL:
Notes: Review -- Source: Scopus
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  1. Michael Morris
    576 Morris