Project objective

Non-small cell lung cancers (NSCLC) present activating mutations of the EGFR in around 10 to 15% of cases , for which targeted therapies exist: EGFR tyrosine kinase inhibitors (TKIs). Therapeutic innovations have led to the recent updating of European and French clinical practice guidelines, justifying the interest in describing the pathways followed by patients with EGFR-mutated NSCLC.

Clustering methods are particularly well-suited to the detailed analysis of care pathways. A clustering method called cluster-tracking has been developed to identify patient clusters in medico-administrative databases, taking into account the longitudinal, multidimensional and truncated characteristics of medico-administrative data, and will be
used for this study.

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Main objective:
The aim of this project is to describe and model the management of patients with advanced or metastatic non-small-cell lung cancer (NSCLC) with EGFR mutation. The aim is to detail the different therapeutic strategies used and to classify patients according to their care pathway.

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Secondary objectives:

Describe patient characteristics
Document procedures for genetic alteration testing and follow-up by treatment line
Analyze healthcare consumption by patients reimbursed by the French health insurance system (Assurance Maladie)

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Target population

Inclusion criteria :
Patients with EGFR-mutated NSCLC or treated with EGFR tyrosine kinase inhibitors during the study period, newly diagnosed at advanced or metastatic stage during the target period (January 1, 2020 to December 31, 2022).

Criteria for non-inclusion:
Patients for whom inclusion in a clinical trial is identified as early as the first anti-cancer treatment sequence, patients under 18 years of age or patients living abroad.

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Data source

To ensure a complete and accurate analysis, the Monarch project draws on data from several recognized sources:

Historical SNDS database :
- DCIR database : this database contains detailed information on reimbursed healthcare, providing a comprehensive view of drug treatments, hospitalizations and medical services used by patients.
- SNIIRAM database: this database provides demographic data and details of healthcare benefits, essential for tracking care pathways and medical consumption.
- PMSI database : the PMSI collects information on hospital diagnoses and procedures, which is crucial for studying the clinical aspects of care pathways.
- Cause-of-death registers: these registers are used to analyze health outcomes and patient survival, making it possible to assess the effectiveness of treatments.
LuCC Lung Cancer Cohort: a database designed specifically to monitor lung cancer patients.

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Patients

Why take part in the project?

Some of your medical and administrative data is collected when you are treated in a healthcare facility. This data is useful for the advancement of research.

This research, conducted in the public interest, aims to develop knowledge in order to develop new treatments or improve the overall management of patients suffering from the same disease as you. If you agree to your data being used for this study, you will not have to make any additional visits or undergo any additional examinations.

Only information already in your medical file will be collected. No directly identifying data (surname, first name or contact details) will be included in the cohorts.

If you wish to object to the processing of your data, you may exercise your rights by informing :

your hospital doctor treating you for lung cancer follow-up or ;
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Lifen's Data Protection Officer at the following address: dpo@lifen.fr ;
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or by completing the opposition form.

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