Clinical trials are designed to test the effect of new drugs and treatments in a highly controlled environment. While this allows researchers to obtain incredibly accurate results, the stark contrast between clinical environments and real world practice means that sometime these therapies may not be as effective as they previously seemed. Here, Paul Richardson, MD, of the Dana-Farber Cancer Institute, Boston, MA, discusses how real world practices must also be taken into account to ensure that the therapies being developed are effective in both settings. Speaking from the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden, Dr Richardson emphasizes that as well as developing highly effective drugs, these treatments should also be tolerable and easily administrable for patient use.