Medicines play a key role in cancer treatment, and innovation in this field has accelerated impressively in recent years, with the massive arrival of targeted therapies and immunotherapy. In its March 2022 Bulletin de veille stratégique, INESSS analyzes Quebec drug spending and trends. Unsurprisingly, spending on anticancer drugs and its growth outstrips that of all other drug classes, whether in the public plan, private insurers or institutions.

This major change in the oncology therapeutic arsenal is profoundly altering patient care, but it also requires us to rethink: 1) the methods used to evaluate and authorize anti-cancer drugs; 2) the framework for their use; 3) the demonstration of their clinical usefulness (value) and their economic and organizational impact. In addition, the majority of anticancer drugs now have orphan designation, i.e. they target rare indications or common indications for restricted sub-populations. As a result, they have the potential to enter the healthcare system on the basis of less robust evidence, and often at a very high price. Against this backdrop, the use of real-life data is essential if we are to continue advancing clinical research in oncology, while at the same time promoting the responsible integration of the resulting innovations. This is the aim of the MEDOnco-VieRéelle platform we are offering at Quebec’s largest hospital center, the CHU de Québec-Université Laval (CHU).

Thanks to data on the care trajectories of cancer patients, securely managed by the CHU’s Centre de valorisation de la donnée (SCIENTA), we will be able to carry out a wide range of research work in response to the issues identified by stakeholders during our consultation process. This work concerns the integration and use of oncology innovations in Quebec clinical practice, the assessment of their impact on real-life survival compared to that observed in clinical trials, their relative efficacy versus real-life comparators, their toxicities and effect on patient quality of life, as well as their organizational and economic repercussions.

MEDOnco-VieRéelle will provide a robust, agile platform of structured, high-quality, ready-to-use (and re-use) data for high-resolution studies to support decision-making: 1) by regulatory agencies on cancer drugs in their development cycle; 2) by healthcare institutions in their value-based management of cancer therapies; 3) by healthcare professionals.le.s in their quest for personalized treatment; and 4) patients in their therapeutic choices. This platform will also be a unique opportunity to develop research capacity around real-life data in oncology in Quebec, and to strengthen the links between research and the clinic.