How Quality Real-World Evidence Is Transforming Clinical Practice in Prostate Cancer Treatment

Sponsored by Johnson & Johnson

Rhonda Stamey, APRN, is a key member of the Advanced Therapy Center Medical Team at First Urology, where she plays an active role in advancing the treatment of prostate cancer. She provides expert insights into the value of real-world evidence and shares her personal experience with how these data can inform clinical decision-making in partnership with her patients. Rhonda is board-certified by the American Association of Nurse Practitioners (AANP) as a family nurse practitioner. She is also a member of both the Kentucky Coalition of Nurse Practitioners & Nurse-Midwives and the Coalition of Advanced Practice Registered Nurses of Indiana. Rhonda has been compensated by J&J for her time to develop this content.

Written by Rhonda Stamey, APRN

A 52-year-old patient with metastatic castration-sensitive cancer (mCSPC) sat across from me, facing a difficult decision. At his previous visit, we discussed treatment with androgen deprivation therapy (ADT) plus an oral oncolytic. Given his disease state, he was eligible for several androgen receptor inhibitors (ARIs), each with unique efficacy and side effect profiles. However, determining the optimal approach wasn’t just about matching the disease to therapy. It also required aligning clinical options with his personal goals, lifestyle considerations, and tolerance to treatment. He asked for time to review the clinical data with his spouse and together discuss his treatment options.

When he returned, he still hadn’t decided. Although the trial results were informative, he said he struggled to see which option truly aligned with his personal goals. That opened the door to a deeper conversation. I asked, “What matters most to you in making the decision?” Without hesitation, he said to live long enough to meet his soon-to-be-born first grandchild. That moment highlighted the complexity of treatment planning. It’s not simply a clinical decision, but a personal one shaped by an individual’s unique preferences and life goals.

As an advanced practice registered nurse (APRN) working closely with urologists, I’ve seen firsthand how multidisciplinary collaboration strengthens patient outcomes. Within this dynamic, data, especially real-world evidence (RWE), plays a critical role.

I rely on data—pivotal clinical trials, progression timelines, and real-world outcomes—to guide treatment conversations with urologists and patients. Charts and notes aren’t just references; they’re a way to show that every recommendation is rooted in evidence. That transparency builds trust, especially when treatment decisions can impact quality of life and long-term outcomes.

From Clinical Trials to Everyday Practice

While randomized clinical trials (RCTs) are considered the gold standard for determining treatment efficacy,¹ RWE can help provide additional evidence of how treatments perform in day-to-day use outside of clinical trial settings.² That evidence, coupled with RCT, can help inform personalized, patient-centered care decisions.³

In the case of my 52-year-old patient with mCSPC, my team reviewed real-world outcomes and clinical trial data to understand how different treatments performed in everyday practice. This approach helped the patient choose a treatment method that aligned with his personal goals, such as attending his grandchild’s birth, highlighting the importance of individualized, evidence-informed decision-making and how RWE serves as a valuable data resource for care teams.

Why Today’s RWE Is Clinically Relevant?

As RWE continues to become a clinically relevant source of data in clinical practice, it allows practitioners to evaluate a wider range of insights when paired with RCT data, offering a more complete picture of treatment outcomes in real-world settings. So that when patients ask, “What will this treatment look like for someone like me,” RWE will help us answer with clarity and confidence, grounded not just in trial data but also the realities of care.

Here’s why modern RWE is clinically relevant:

• Diverse Data Sources – RWE can include data from EHRs, genomic databases, patient-reported outcomes, and real-time registries, providing a comprehensive picture of treatment effectiveness and patient outcomes.²
• Broader Patient Representation – RWE includes patients who reflect the diversity of real-world practice—including older adults and those with comorbid conditions.²
• Long-Term & Comparative Insights – RWE can enable us to track treatment efficacy, side effects, and survival outcomes over time, helping refine treatment decisions based on how therapies perform in the real world.³

Applying RWE in Prostate Cancer Treatment Decisions

Every patient’s life circumstances are different, which is why real-world evidence is so valuable.

I think of a patient with prostate cancer who had a PSA of 92 and asked how quickly it might drop. I pointed to real-world data from a recent study and explained, “Here’s what we’ve seen outside of clinical trials.” That kind of evidence is powerful. It helps patients feel informed, reassured, and part of the decision-making process.

In some cases, RWE can help support more informed treatment decisions by providing comparative insights on available therapies.⁴

A More Patient-Centered Approach to Prostate Cancer Care

If I had a family member facing the decision between several treatment options, I’d want them to have access to more than just controlled-study data. I’d want them to know how treatment performs in the real world because that’s where their life is happening. Not in a document.

For advanced practice providers (APPs), oncologists, and urologists alike, that’s what RWE brings to the table. It’s no longer just supplementary data—it’s essential to delivering evidence-based, patient-centered prostate cancer care. RWE is not a future; it is a present necessity.

By incorporating real-world insights alongside clinical trial data, we gain a more complete picture of how therapies perform across our diverse patient populations, in everyday clinical practice, and over extended periods. This allows us to:

• Make more informed, data-driven treatment decisions.
• Understand how therapies impact patients beyond controlled clinical trials.
• Guide patients with practical insights into what to expect from treatment and point them toward resources that can help support them through it.

Today, clinical trials still drive many of our decisions. Ultimately, RWE will help us move from “one-size-fits-all” to what fits best for this person in front of me.

It turns data into meaningful, human care. And for APRNs like me, it’s become an essential part of how we care for men with prostate cancer every day.

References

1. Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med. 2000;342:1887–1892. https://www.nejm.org/doi/full/10.1056/NEJM200006223422507
2. Blonde L, Khunti K, Harris SB, et al. Interpretation and Impact of Real-World Clinical Data for the Practicing Clinician. Adv Ther. 2018;35(11):1763-1774. doi: 10.1007/s12325-018-0805-y
3. Costa V, Custodio MG, Gefen E, et al. The relevance of the real-world evidence in research, clinical, and regulatory decision making. Front Public Health. 2025;13:1512429. https://doi.org/10.3389/fpubh.2025.1512429
4. Daigl M, Abogunrin, Castro F. Advancing the role of real-world evidence in comparative effectiveness research. Clinical and Experimental Research. 2024;1(1), 5–12. https://doi.org/10.57264/cer-2024-0101

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