Improving lung cancer care using real-world data

In this thesis, we wanted to investigate the association between lung cancer diagnostic delays and survival in a single Finnish cancer centre. In recent years, many centres have introduced fast-track diagnostic and treatment procedures for lung cancer, but it is uncertain whether they improve survival. In our study, shorter time intervals were not associated with improved survival, suggesting that fast-track approaches are unlikely to improve the survival of lung cancer patients.
EGFR TKIs have significantly improved progression-free survival of NSCLC patients with sensitizing EGFR mutations. However, TKIs are associated with significant and disabling side effects, like rash and diarrhoea, which adversely affect quality of life and treatment compliance. In turn, it has been shown that patients who develop skin rash are more likely to respond to treatment. Rash can be relieved with tetracycline antibiotics and topical corticosteroids. Prophylactic use of tetracyclines has been shown to inhibit the severity of TKI rash, but it is unknown whether prophylactic use of tetracyclines and topical corticosteroids can increase the survival of NSCLC patients treated with EGFR TKIs.
In this study, we present the results of a large nationwide cohort of patients treated with EGFR TKIs for NSCLC indication, using wide real-world registries. We found that prophylactic use of tetracyclines and topical corticosteroids can improve the survival of NSCLC patients treated with EGFR TKIs with high incidence of rash.