Utilization of immune checkpoint inhibitors for the treatment of cancer in Scotland, 2018–2024: A national retrospective cohort study
- 1Strathclyde Institute of Pharmacy and Biomedical Sciences University of Strathclyde Glasgow UK
- 2Public Health Scotland Glasgow/Edinburgh UK
- 3NHS Greater Glasgow and Clyde Glasgow UK
Abstract
Aims: The aim of the study is to describe the use of immune checkpoint inhibitors (ICIs) for the treatment of cancer in Scotland.
Methods: The retrospective observational cohort study included patients aged 18 years or older who commenced treatment with an ICI in Scotland between 1 January 2018 and 31 December 2024. The National Systemic Anti‐Cancer Therapy (SACT) dataset was used to identify patients and obtain details on ICI treatments and patient characteristics. Additional data sources providing information on comorbidities were linked deterministically via a unique patient identifier. All analyses were descriptive.
Results: In total, 10 394 patients in Scotland initiated their first ICI treatment between 2018 and 2024; the number of patients initiating ICIs increased substantially year‐on‐year, from 764 patients in 2018 to 2233 patients in 2024. The most commonly prescribed ICI was pembrolizumab (56.8%, n = 5908), followed by nivolumab (16.4%, n = 1700) and atezolizumab (11.3%, n = 1170); treatment was most commonly initiated for lung and chest cancers (44.1%, n = 4585), skin cancer (18.8%, n = 1955) and urological cancers (14.8%, n = 1539). While the majority of patients (66.6%, n = 6923) initiated ICI monotherapy, combination therapies—most commonly ICI with chemotherapy (18.4%, n = 1910)—were also used. Overall, 6.6% of patients (n = 681) were on treatment for more than 2 years.
Conclusions: With the continuous addition of new ICIs, alongside the ever‐expanding list of approved indications for their use, the observed increase in ICI use is expected to continue. This increasing use of ICIs may pose challenges to health services—for instance, an increase in immune‐related adverse effects—with potential implications for clinical practice and future research.
Related
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BibTeX
@article{mueller2026utilization,
title = {{Utilization of immune checkpoint inhibitors for the treatment of cancer in Scotland, 2018–2024: A national retrospective cohort study}},
author = {Tanja Mueller and Christine Crearie and Liya Lu and Jiafeng Pan and Fraser N. Sneden and David Martin and Amanj Kurdi and Catherine S. Thomson and Julie Clarke and Marion Bennie},
journal = {British Journal of Clinical Pharmacology},
year = {2026},
month = jul,
doi = {10.1002/bcp.70700},
url = {https://doi.org/10.1002/bcp.70700},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Utilization of immune checkpoint inhibitors for the treatment of cancer in Scotland, 2018–2024: A national retrospective cohort study
AU - Tanja Mueller
AU - Christine Crearie
AU - Liya Lu
AU - Jiafeng Pan
AU - Fraser N. Sneden
AU - David Martin
AU - Amanj Kurdi
AU - Catherine S. Thomson
AU - Julie Clarke
AU - Marion Bennie
PY - 2026
DA - 2026/07/20
JO - British Journal of Clinical Pharmacology
DO - 10.1002/bcp.70700
UR - https://doi.org/10.1002/bcp.70700
AB - Aims: The aim of the study is to describe the use of immune checkpoint inhibitors (ICIs) for the treatment of cancer in Scotland. Methods: The retrospective observational cohort study included patients aged 18 years or older who commenced treatment with an ICI in Scotland between 1 January 2018 and 31 December 2024. The National Systemic Anti‐Cancer Therapy (SACT) dataset was used to identify patients and obtain details on ICI treatments and patient characteristics. Additional data sources providing information on comorbidities were linked deterministically via a unique patient identifier. All analyses were descriptive. Results: In total, 10 394 patients in Scotland initiated their first ICI treatment between 2018 and 2024; the number of patients initiating ICIs increased substantially year‐on‐year, from 764 patients in 2018 to 2233 patients in 2024. The most commonly prescribed ICI was pembrolizumab (56.8%, n = 5908), followed by nivolumab (16.4%, n = 1700) and atezolizumab (11.3%, n = 1170); treatment was most commonly initiated for lung and chest cancers (44.1%, n = 4585), skin cancer (18.8%, n = 1955) and urological cancers (14.8%, n = 1539). While the majority of patients (66.6%, n = 6923) initiated ICI monotherapy, combination therapies—most commonly ICI with chemotherapy (18.4%, n = 1910)—were also used. Overall, 6.6% of patients (n = 681) were on treatment for more than 2 years. Conclusions: With the continuous addition of new ICIs, alongside the ever‐expanding list of approved indications for their use, the observed increase in ICI use is expected to continue. This increasing use of ICIs may pose challenges to health services—for instance, an increase in immune‐related adverse effects—with potential implications for clinical practice and future research.
SN - 0306-5251
SN - 1365-2125
ER -