PROFOUND-VET: Real-World Evidence for Cancer Care

PROFOUND-VET (Partnership for Real-world Outcomes, Findings, and Observations Using National Data on Veterans) is a coordinated initiative within the VA healthcare system designed to generate guideline-informing real-world evidence across cancer care, not limited to any single cancer type. By standardizing data definitions, analytical workflows, and collaboration across VA's national investigator network, the initiative is building infrastructure for comparative effectiveness research that other cancer types are expected to draw on as the program grows. Its pilot phase focused on prostate cancer, completing two comparative effectiveness studies — examining docetaxel rechallenge versus cabazitaxel in metastatic castration-resistant prostate cancer, and multiparametric MRI versus confirmatory biopsy for active surveillance eligibility — with findings incorporated into the VA Oncology Clinical Pathway for Prostate Cancer.