Understanding How Common Medicines Influence Cancer Immunotherapy Success Through Real-World Health Data (VENABLESZ_U26FMH)

Immune checkpoint inhibitors have transformed cancer care and are now integral to treatment pathways across multiple tumour types, with melanoma representing one of the earliest and most successful examples. However, a major evidence gap remains in understanding how commonly prescribed concomitant medications (e.g. antibiotics, metformin, proton pump inhibitors, corticosteroids) influence immunotherapy effectiveness and survival outcomes. This has been identified as a NICE-recommended research priority [1], reflecting its importance for optimising real-world cancer outcomes.

This PhD will deliver an original, staged programme of research evaluating the impact of routine medication exposure on immunotherapy outcomes. Melanoma will serve as the initial focus, with extension to other immunotherapy-treated cancers to enable cross-cancer comparison and broader generalisability. The project will leverage two complementary data sources: the TrinetX global research network for early hypothesis generation and descriptive/comparative analyses, alongside parallel applications for access to row-level registry-linked datasets (e.g.

National Disease Registration Service and other established platforms such as UK Biobank), which are essential for advanced methodological training and causal inference. Methodologically, the PhD will employ propensity score–matched cohort designs and Cox proportional hazards regression to estimate associations with overall and disease-specific survival. Time-v