The treatment of lung cancer, particularly non-small cell lung cancer (NSCLC), remains challenging despite advances in targeted therapies (SMIs) and immunotherapies. This dissertation focuses on three key issues: drug interactions, biomarkers for immunotherapy, and the use of pemetrexed in patients with impaired kidney function. Our research shows that interactions between SMIs and blood thinners (DOACs) often require dose adjustments or alternatives to prevent bleeding or thrombosis. Additionally, we found that the clearance of immunotherapies such as nivolumab and pembrolizumab can help predict which patients will benefit from treatment, reducing unnecessary costs and side effects. We also demonstrate that a predictive biomarker in immunotherapy can be cost-saving, though potentially at the expense of survival. Finally, we show that pemetrexed can be safely administered to patients with kidney impairment, granting them access to this treatment. Our findings may contribute to safer, more effective, and cost-efficient NSCLC therapies.
Leila-Sophie Otten (1992) obtained her pharmacy degree in 2019 and subsequently worked at the Jeroen Bosch Hospital and the Radboudumc. In 2021, Leila-Sophie started her PhD research at the Department of Pharmacy, Pharmacology and Toxicology of the Radboudumc. As of January 2025, Leila-Sophie has started as a hospital pharmacist in training at the Radboudumc.