Lectures and seminars Faculty event: Cecilia Radkiewicz

Title

The Swedish Anti-Cancer Therapy (SeACT) initiative

Abstract 

Cecilia is the primary investigator of the SeACT project, an academic initiative based at MEB to collect Swedish medical record data on cancer drugs from the electronic prescription systems to conduct pharmacoepidemiological studies on cancer treatment in Sweden. 

Background: Around 70, 000 individuals are diagnosed with malignancy in Sweden each year. Incidence is increasing, while a larger proportion of cancer patients are being cured or live longer with cancer. Early detection and treatment, as well as new medications and optimized treatment algorithms, have contributed to this. In routine healthcare, the impact on mortality is however lower and the risk of side effects higher compared to clinical trials on selected patient groups with short follow-up. Most cancer drugs are not dispensed at pharmacies but requisitioned to and administered at hospital-based oncology clinics and therefore not covered in the National Prescribed Drug Register. Despite serious side effects and high drug costs, it is today not possible to systematically monitor the effectiveness and safety of cancer drugs in Sweden.

Main Objective: To perform phase IV (real-world data) studies on the short- and long-term effects and safety, as well as access to cancer drugs in a Swedish population-based setting.

Study Design and Data Collection: Since around 20 years back, detailed information on requisition cancer drugs is stored in a handful of electronic prescription systems (Cytodos, CytoBase, and Mosaiq) in Sweden. We plan to link treatment data from these prescription systems and the National Prescribed Drug Register to all individuals in the National Cancer Register. Subsequently the cancer cohort will be linked to other population-based health and demographic registers. The statistical analysis will be carried out as a series of retrospective cohort studies where we (depending on the specific research question) will follow Swedish cancer patients from date of diagnosis, relapse, surgery, or treatment start. The focus is real-world cancer survival but also to assess acute and late side effects, comparing treatments and patient groups. We will also study how these outcomes are affected by age, sex, comorbidity, and other medications.

Timeline: As of 2024, requests are being submitted to all Swedish healthcare regions/providers to obtain anti-cancer therapy data from their respective electronic prescription system. We hope to have collected the treatment data by mid-2025, and the first sub-study is expected to be submitted for publication in 2026.

In addition to numerous site-specific and pan-tumor research questions, I will give examples on how we plan to use real-world cancer therapy data to study real-world effects of chemotherapy in young colorectal cancer patients. 

About the speaker 

Cecilia Radkiewicz is a medical oncologist working with colorectal cancer at Capio Sankt Görans Sjukhus who defended her thesis on sex differences in cancer risk and survival in 2019 and is still affiliated at MEB. She was thereafter (2020-2022) the director of studies for the research school in epidemiology for clinicians (KEP/KI), and at the moment (2022-2025) holds a clinical postdoc position in upper gastrointestinal cancer epidemiology in prof. Jesper Lagergren's group at MMK/KI.

Join the faculty event in Wargentin! After the seminar, the faculty lunch will be served in Ljusgården.