# Linked prescribing and outcome data to find drug interactions with cancer therapy

Source: https://onco.cc/ideas/idea-data-linked-pharmacovigilance-interactions/  
OnCo record `idea-data-linked-pharmacovigilance-interactions` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Use joined-up pharmacy and hospital records to spot when a common everyday medicine makes a cancer drug work worse or cause more harm.

## Summary

Interactions between anticancer agents and common co-medications (proton pump inhibitors with some kinase inhibitors and capecitabine; antibiotics and steroids with immunotherapy) have emerged from retrospective analyses years after approval. The proposal is a standing surveillance system using linked prescribing and outcome data that screens all new oncology drugs against the 200 most common co-medications, with signals triaged to confirmatory analysis or trials.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Systematic screening will detect clinically relevant interactions for new drugs within 18 months of approval, compared with a historical median of several years.
- Rationale: The PPI and capecitabine signal and the antibiotic and immunotherapy signal were both found in retrospective trial and registry analyses; a systematic screen would have found them sooner.
- Proposed test: Run the screen on five drugs approved three or more years ago; check whether it rediscovers known interactions and how many new signals it produces; validate the top signals in independent data.
- Maturity: early-clinical
- Actor: data

## Sources

- Bottleneck evidence (Weak real-world evidence and registries): Gyawali, Hey & Kesselheim, Assessment of the clinical benefit of cancer drugs receiving accelerated approval (JAMA Intern Med 2019): https://doi.org/10.1001/jamainternmed.2019.0462

## Connected records

- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/)
- terms: [Real-world evidence](https://onco.cc/terms/real-world-evidence/)
- bottlenecks: [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/), [Weak real-world evidence and registries](https://onco.cc/bottlenecks/b-real-world-evidence/)
- key papers: [Assessment of the Clinical Benefit of Cancer Drugs Receiving Accelerated Approval](https://onco.cc/key-papers/paper-gyawali-jama-intern-med/)

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