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López-Fernández FJ, Mezquita L, Etkin P, Griffiths MD, Ortet G, Ibáñez MI. The Role of Violent Video Game Exposure, Personality, and Deviant Peers in Aggressive Behaviors Among Adolescents: A Two-Wave Longitudinal Study. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 24:32-40. [PMID: 33252248 DOI: 10.1089/cyber.2020.0030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The impact of violent video game exposure (VVGE) on aggressive behaviors has been extensively explored, but still remains controversial. Although some studies have shown slight detrimental short-term effects of VVGE, other studies have failed to find any consequence. In addition, the existence of long-lasting effects on aggressiveness, or their impact on adolescents, are still not well established. One limitation of most of these studies is that they do not control for other important risk variables for aggressive behaviors, such as personality and deviant peers, nor have they investigated the possible moderation role of these risk factors in the link between VVGE and aggression. Therefore, the main aim was to examine the additive and interactive role of VVGE, personality, and deviant peers in adolescent aggressive behaviors cross-sectionally and longitudinally. Many regression analyses and a cross-lagged autoregressive model were carried out. At both waves, aggressive behavior was predicted by having deviant peers and specific personality traits, especially low agreeableness. VVGE also presented a slight but significant effect at both waves, but it became nonsignificant when controlling for other variables. No long-term effects on the relation between VVGE and aggressive behaviors were found. Some moderation effects were consistently found at both waves: when participants reported having more deviant peers, the effects of VVGE and low agreeableness on aggressive behaviors significantly increased. These findings suggest that multiple biopsychosocial variables and their complex interplay need to be examined to gain a better understanding of the origin and expression of aggressive behavior.
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Auclin E, Vuagnat P, Smolenschi C, Taieb J, Alfonso JA, Nebot L, Garcia de Herreros M, Tocino RV, Longo F, El Dakdouki Y, Romano PM, Alvarez EC, Garcia-Carbonero R, Garcia LG, Nadal TS, Oliveres H, Besse B, Massard C, Mezquita L, Hollebecque A. 2P Lung immune prognostic index (LIPI) can identify the fast-progressor to immune checkpoints inhibitors (ICI) in microsatellite instability (MSI) or mismatch repair deficient (dMMR) tumours. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Marin E, Reyes R, Arcocha A, Viñolas N, Mezquita L, Gonzalvo E, Saez de Gordoa K, Jares P, Reguart N, Teixido C. Prospective Evaluation of Single Nucleotide Variants by Two Different Technologies in Paraffin Samples of Advanced Non-Small Cell Lung Cancer Patients. Diagnostics (Basel) 2020; 10:E902. [PMID: 33153192 PMCID: PMC7693424 DOI: 10.3390/diagnostics10110902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 11/17/2022] Open
Abstract
Targeted therapies are a new paradigm in lung cancer management. Next-generation sequencing (NGS) techniques have allowed for simultaneous testing of several genes in a rapid and efficient manner; however, there are other molecular diagnostic tools such as the nCounter® Vantage 3D single nucleotide variants (SNVs) solid tumour panel which also offer important benefits regarding sample input and time-to-response, making them very attractive for daily clinical use. This study aimed to test the performance of the Vantage panel in the routine workup of advanced non-squamous non-small cell lung cancer (NSCLC) patients and to validate and compare its outputs with the Oncomine Solid Tumor (OST) panel DNA kit, the standard technique in our institution. Two parallel multiplexed approaches were performed based on DNA NGS and direct digital detection of DNA with nCounter® technology to evaluate SNVs. A total of 42 advanced non-squamous NSCLC patients were prospectively included in the study. Overall, 95% of samples were successfully characterized by both technologies. The Vantage panel accounted for a sensitivity of 95% and a specificity of 82%. In terms of predictive values, the probability of truly presenting the SNV variant when it is detected by the nCounter panel was 82%, whereas the probability of not presenting the SNV variant when it is not detected by the platform was 95%. Finally, Cohen's Kappa coefficient was 0.76, indicating a substantial correlation grade between OST and Vantage panels. Our results make nCounter an analytically sensitive, practical and cost-effective tool.
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Ferrara R, Mezquita L, Texier M, Lahmar J, Audigier-Valette C, Tessonnier L, Mazieres J, Zalcman G, Brosseau S, Le Moulec S, Leroy L, Duchemann B, Lefebvre C, Veillon R, Westeel V, Koscielny S, Champiat S, Ferté C, Planchard D, Remon J, Boucher ME, Gazzah A, Adam J, Lo Russo G, Signorelli D, Garassino MC, Soria JC, Caramella C, Besse B. Comparison of Fast-Progression, Hyperprogressive Disease, and Early Deaths in Advanced Non–Small-Cell Lung Cancer Treated With PD-1/PD-L1 Inhibitors or Chemotherapy. JCO Precis Oncol 2020; 4:829-840. [DOI: 10.1200/po.20.00021] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Hyperprogressive disease (HPD), fast progression (FP), and early death (ED) have been described in 13.8%, 4.7%, and 5.6% and in 5.1%, 2.8%, and 6.8%, respectively, of patients with non–small-cell lung cancer (NSCLC) treated with single-agent programmed cell death ligand 1 inhibitors (ICI) or chemotherapy, respectively. Whether FP/ED and HPD represent overlapping patterns is unknown. PATIENTS AND METHODS FP, ED, and HPD were retrospectively assessed in patients with NSCLC treated with single-agent ICI or chemotherapy. Eligibility required 2 computed tomography (CT) scans before and 1 CT scan during treatment. (1) HPD, (2) FP, (3) ED were defined as (1) RECIST version 1.1 progression at first CT scan and tumor growth rate variation per month > 50%, (2) ≥ 50% increase in the sum of the longest diameters of target lesions within 6 weeks from baseline, and (3) death as a result of radiologic progression within 12 weeks from baseline CT scan, respectively. RESULTS Of 406 ICI-treated NSCLC, 56 patients (13.8%), 9 patients (2.2%), and 36 patients (8.8%) were HPD, FP, and ED, respectively. Eight (14.2%) and 20 (35.7%) of 56 patients with HPD were also FP and ED. ED significantly correlated with baseline Eastern Cooperative Oncology Group performance status ≥ 2 compared with HPD (33% v 13%, P = .02). Overall survival was significantly longer for HPD (3.4 months [95% CI, 2.7 to 4.0 months]) compared with FP (0.7 months [95% CI, 0.6 to 0.8 months]); HR, 0.18 [95% CI, 0.08 to 0.42]; P < .0001) and ED (1.4 months [95% CI, 1.3 to 1.6 months]); HR, 0.19 [95% CI, 0.11 to 0.34]); P < .0001), whereas it did not differ between FP and ED (HR, 1.3 [95% CI, 0.56 to 3.0]; P = .55). Of 59 patients with NSCLC treated with single-agent chemotherapy, the HPD, FP, and ED rates were 5.1%, 1.7%, and 6.7%, respectively. CONCLUSION FP, ED, and HPD represent distinct progression patterns with limited overlap and different survival outcomes.
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Corgnac S, Malenica I, Mezquita L, Auclin E, Voilin E, Kacher J, Halse H, Grynszpan L, Signolle N, Dayris T, Leclerc M, Droin N, de Montpréville V, Mercier O, Validire P, Scoazec JY, Massard C, Chouaib S, Planchard D, Adam J, Besse B, Mami-Chouaib F. CD103 +CD8 + T RM Cells Accumulate in Tumors of Anti-PD-1-Responder Lung Cancer Patients and Are Tumor-Reactive Lymphocytes Enriched with Tc17. CELL REPORTS MEDICINE 2020; 1:100127. [PMID: 33205076 PMCID: PMC7659589 DOI: 10.1016/j.xcrm.2020.100127] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 07/24/2020] [Accepted: 09/24/2020] [Indexed: 12/23/2022]
Abstract
Accumulation of CD103+CD8+ resident memory T (TRM) cells in human lung tumors has been associated with a favorable prognosis. However, the contribution of TRM to anti-tumor immunity and to the response to immune checkpoint blockade has not been clearly established. Using quantitative multiplex immunofluorescence on cohorts of non-small cell lung cancer patients treated with anti-PD-(L)1, we show that an increased density of CD103+CD8+ lymphocytes in immunotherapy-naive tumors is associated with greatly improved outcomes. The density of CD103+CD8+ cells increases during immunotherapy in most responder, but not in non-responder, patients. CD103+CD8+ cells co-express CD49a and CD69 and display a molecular profile characterized by the expression of PD-1 and CD39. CD103+CD8+ tumor TRM, but not CD103−CD8+ tumor-infiltrating counterparts, express Aiolos, phosphorylated STAT-3, and IL-17; demonstrate enhanced proliferation and cytotoxicity toward autologous cancer cells; and frequently display oligoclonal expansion of TCR-β clonotypes. These results explain why CD103+CD8+ TRM are associated with better outcomes in anti-PD-(L)1-treated patients. A high density of CD103+CD8+ cells in tumors correlates with response to anti-PD-(L)1 The density of CD103+CD8+ cells increases after anti-PD-1 in most responder patients CD103+CD8+ TRM cells are enriched with tumor-specific T cells A subset of CD103+CD8+ TRM cells display a Tc17 differentiation program
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De Giglio A, Mezquita L, Auclin E, Blanc-Durand F, Riudavets M, Caramella C, Martinez G, Benitez JC, Martín-Romano P, El-Amarti L, Hendriks L, Ferrara R, Naltet C, Lavaud P, Gazzah A, Adam J, Planchard D, Chaput N, Besse B. Impact of Intercurrent Introduction of Steroids on Clinical Outcomes in Advanced Non-Small-Cell Lung Cancer (NSCLC) Patients under Immune-Checkpoint Inhibitors (ICI). Cancers (Basel) 2020; 12:E2827. [PMID: 33007977 PMCID: PMC7599488 DOI: 10.3390/cancers12102827] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Baseline steroids before ICI have been associated with poor outcomes, particularly when introduced due to cancer symptoms. METHODS Retrospective analysis of advanced NSCLC patients treated with ICI. We collected the use of intercurrent steroids (≥10 mg of prednisone-equivalent) within the first eight weeks of ICI. We correlated steroid use with patient outcomes according to the indications. RESULTS 413 patients received ICI, 299 were steroids-naïve at baseline. A total of 49 patients received intercurrent steroids (16%), of whom 38 for cancer-related symptoms and 11 for other indications, such as immune-related events. Overall, median (m) progression-free survival (PFS) was 1.9 months (mo.) [95% CI, 1.8-2.4] and overall survival (OS) 10 mo. [95% CI, 8.1-12.9]. Intercurrent steroids under ICI correlated with a shorter PFS/OS (1.3 and 2.3 mo. respectively, both p < 0.0001). Intercurrent steroids for cancer-related symptoms correlated with poorest mPFS [1.1 mo.; 95% CI, 0.9-1.5] and mOS [1.9 mo.; 95%CI, 1.5-2.4; p < 0.0001)]. No mOS and mPFS differences were found between cancer-unrelated-steroid group and no-steroid group. Steroid use for cancer-related symptoms was an independent prognostic factor for poor PFS [HR 2.64; 95% CI, 1.2-5.6] and OS [HR 4.53; 95% CI, 1.8-11.1], both p < 0.0001. CONCLUSION Intercurrent steroids during ICI had no detrimental prognostic impact if the indication was unrelated to cancer symptoms.
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Lefebvre C, Martin E, Hendriks LEL, Veillon R, Puisset F, Mezquita L, Ferrara R, Sabatier M, Filleron T, Dingemans AMC, Besse B, Raherisson C, Mazières J. Immune checkpoint inhibitors versus second line chemotherapy for patients with lung cancer refractory to first line chemotherapy. Respir Med Res 2020; 78:100788. [PMID: 32980653 DOI: 10.1016/j.resmer.2020.100788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/17/2020] [Accepted: 08/20/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Anti Programmed Death-ligand (PD1/PD-L1) directed immune-checkpoint-inhibitors (ICI) are widely used to treat patients with advanced non-small cell lung cancer (NSCLC) who progress after first line chemotherapy. The best strategy after early progression under first line has not been specifically studied. PATIENTS AND METHODS We conducted a multicenter, retrospective study including all consecutive NSCLC patients progressing within the first 3 months following introduction of first-line chemotherapy and being treated with second line ICI monotherapy or chemotherapy between March 2010 and November 2017. We analysed the clinicopathological data and outcome under second line chemotherapy vs. second line ICI: objective response rate (ORR), progression-free survival (PFS), overall survival (OS. RESULTS We identified 176 patients with refractory disease, 99 who received subsequent immunotherapy and 77 undergoing chemotherapy. The 2 populations were comparable regarding the main prognostic criteria, median age was 60, main histology was adenocarcimoma (68.2%). PFS was not significantly different between both treatments 1.9 [1.8-2.1] versus 1.6 month [1.4-2.0] (P=0.125). Compared to chemotherapy, ICI treated patients had a superior OS (P=0.03) (Median [95% CI] OS 4.6 [2.8-6.7] versus 4.2 months [3.4-5.9] and a non-significant improvement in ORR (17.2% versus 7.9%, respectively, P=0.072). Poor performance status (ECOG PS≥2) and a higher number of metastatic sites (≥3) were associated with poorer prognosis. KRAS-mutated patients did not seem to benefit more from ICI than chemotherapy. CONCLUSIONS ICI appears to be the preferred second-line treatment for patients who are refractory to first line chemotherapy.
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Ferrara R, Naigeon M, Auclin E, Duchemann B, Cassard L, Jouniaux JM, Boselli L, Grivel J, Desnoyer A, Mezquita L, Texier M, Caramella C, Hendriks L, Planchard D, Remon J, Sangaletti S, Proto C, Garassino MC, Soria JC, Marabelle A, Voisin AL, Farhane S, Besse B, Chaput N. Circulating T-cell Immunosenescence in Patients with Advanced Non-small Cell Lung Cancer Treated with Single-agent PD-1/PD-L1 Inhibitors or Platinum-based Chemotherapy. Clin Cancer Res 2020; 27:492-503. [PMID: 32887723 DOI: 10.1158/1078-0432.ccr-20-1420] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/15/2020] [Accepted: 08/31/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE CD28, CD57, and KLRG1 have been previously identified as markers of T-cell immunosenescence. The impact of immunosenescence on anti-PD(L)-1 (ICI) or platinum-based chemotherapy (PCT) in patients with advanced non-small cell lung cancer (aNSCLC) is unknown. EXPERIMENTAL DESIGN The percentage of CD28-, CD57+, KLRG1+ among CD8+ T cells [senescent immune phenotype (SIP)] was assessed by flow cytometry on blood from patients with aNSCLC before single-agent ICI (discovery cohort). A SIP cut-off was identified by log-rank maximization method and patients with aNSCLC treated with ICI (validation cohort) or PCT were classified accordingly. Proliferation and functional properties of SIP+ CD8+ T cells were assessed in vitro. RESULTS In the ICI discovery cohort (N = 37), SIP cut-off was 39.5%, 27% of patients were SIP+. In the ICI validation cohort (N = 46), SIP+ status was found in 28% of patients and significantly correlated with worse objective response rate (ORR; 0% vs. 30%, P = 0.04), median progression-free survival (PFS) [1.8 (95% confidence interval (CI), 1.3-NR) vs. 6.4 (95% CI, 2-19) months, P = 0.009] and median overall survival, OS [2.8 (95% CI, 2.0-NR) vs. 20.8 (95% CI, 6.0-NR) months, P = 0.02]. SIP+ status was significantly associated with circulating specific immunephenotypes, in vitro lower CD8+ T cells proliferation, lower IL2 and higher TNFα and IFNγ production. In the ICI-pooled population (N = 83), SIP+ status did not correlate with any clinical characteristics and it was associated with significantly worse ORR, PFS, and OS. In PCT cohort (N = 61), 11% of patients were SIP+. SIP status did not correlate with outcomes upon PCT. CONCLUSIONS Circulating T-cell immunosenescence is observed in up to 28% of patients with aNSCLC and correlates with lack of benefit from ICI but not from PCT.See related commentary by Salas-Benito et al., p. 374.
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Carneiro A, Amaral T, Brandao M, Scheffler M, Bol K, Ferrara R, Jalving M, Lo Russo G, Marquez-Rodas I, Matikas A, Mezquita L, Morgan G, Onesti C, Pilotto S, Saloustros E, Trapani D. LBA66_PR Disparities in access to oncology clinical trials in Europe in the period 2009-2019. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Seguí E, García de Herreros M, Auclin E, Mirallas O, Casadevall D, Rodriguez M, Epaillard N, Tagliamento M, Pilotto S, López-Castro R, Mielgo X, Urbano C, Pesántez D, Saoudi N, Bluthgen M, Masfarré L, Minatta J, Cruz C, Mezquita L, Prat A. 1681P First results of the COCO study: COVID-19 outcomes in patients with cancer. Ann Oncol 2020. [PMCID: PMC7506441 DOI: 10.1016/j.annonc.2020.08.1745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ghiglione L, Auclin E, Aguilar-Company J, Epaillard N, Casadevall Aguilar D, Masfarré L, Rodriguez Castells M, Tagliamento M, Pilotto S, Lopez Castro R, Mielgo Rubio X, Urbano Centella C, Laguna J, García-Illescas D, Bluthgen M, Gorría Puga T, Minatta J, Cruz C, Prat A, Mezquita L. 1726P Expanding the role of medical oncologist in the management of COVID-19. Ann Oncol 2020. [PMCID: PMC7506355 DOI: 10.1016/j.annonc.2020.08.1790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Seguí E, Auclin E, Casadevall D, Aguilar-Company J, Rodriguez M, Epaillard N, Tagliamento M, Pilotto S, López-Castro R, Mielgo X, Urbano C, Rodríguez A, García-Illescas D, Bluthgen M, Masfarré L, Oliveres H, Minatta J, Marco-Hernández J, Prat A, Mezquita L. 1714P Change of circulating pro-inflammatory markers between pre-COVID-19 condition and COVID-19 diagnosis predicts early death in cancer patients: The FLARE score. Ann Oncol 2020. [PMCID: PMC7506416 DOI: 10.1016/j.annonc.2020.08.1778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Etkin P, Mezquita L, López-Fernández FJ, Ortet G, Ibáñez MI. Five Factor model of personality and structure of psychopathological symptoms in adolescents. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.110063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ortiz-Cuaran S, Mezquita L, Swalduz A, Aldea M, Mazieres J, Leonce C, Jovelet C, Pradines A, Avrillon V, Chumbi Flores WR, Lacroix L, Loriot Y, Westeel V, Ngo-Camus M, Tissot C, Raynaud C, Gervais R, Brain E, Monnet I, Giroux Leprieur E, Caramella C, Mahier-Aït Oukhatar C, Hoog-Labouret N, de Kievit F, Howarth K, Morris C, Green E, Friboulet L, Chabaud S, Guichou JF, Perol M, Besse B, Blay JY, Saintigny P, Planchard D. Circulating Tumor DNA Genomics Reveal Potential Mechanisms of Resistance to BRAF-Targeted Therapies in Patients with BRAF-Mutant Metastatic Non-Small Cell Lung Cancer. Clin Cancer Res 2020; 26:6242-6253. [PMID: 32859654 DOI: 10.1158/1078-0432.ccr-20-1037] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 06/11/2020] [Accepted: 08/20/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE The limited knowledge on the molecular profile of patients with BRAF-mutant non-small cell lung cancer (NSCLC) who progress under BRAF-targeted therapies (BRAF-TT) has hampered the development of subsequent therapeutic strategies for these patients. Here, we evaluated the clinical utility of circulating tumor DNA (ctDNA)-targeted sequencing to identify canonical BRAF mutations and genomic alterations potentially related to resistance to BRAF-TT, in a large cohort of patients with BRAF-mutant NSCLC. EXPERIMENTAL DESIGN This was a prospective study of 78 patients with advanced BRAF-mutant NSCLC, enrolled in 27 centers across France. Blood samples (n = 208) were collected from BRAF-TT-naïve patients (n = 47), patients nonprogressive under treatment (n = 115), or patients at disease progression (PD) to BRAF-TT (24/46 on BRAF monotherapy and 22/46 on BRAF/MEK combination therapy). ctDNA sequencing was performed using InVisionFirst-Lung. In silico structural modeling was used to predict the potential functional effect of the alterations found in ctDNA. RESULTS BRAFV600E ctDNA was detected in 74% of BRAF-TT-naïve patients, where alterations in genes related with the MAPK and PI3K pathways, signal transducers, and protein kinases were identified in 29% of the samples. ctDNA positivity at the first radiographic evaluation under treatment, as well as BRAF-mutant ctDNA positivity at PD were associated with poor survival. Potential drivers of resistance to either BRAF-TT monotherapy or BRAF/MEK combination were identified in 46% of patients and these included activating mutations in effectors of the MAPK and PI3K pathways, as well as alterations in U2AF1, IDH1, and CTNNB1. CONCLUSIONS ctDNA sequencing is clinically relevant for the detection of BRAF-activating mutations and the identification of alterations potentially related to resistance to BRAF-TT in BRAF-mutant NSCLC.
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Chen J, Braye F, Facchinetti F, Lacroix L, Scoazec JY, Tselikas L, Planchard D, Mezquita L, Gazzah A, Naltet C, Lavaud P, Maillard A, Michiels S, Massard C, Olaussen K, André F, Vassal G, Soria JC, Besse B, Friboulet L. Abstract 1867: Characterization of multiple driver alterations in acquired resistance to osimertinib in EGFR-mutated lung cancer: implementation of single cell approaches. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-1867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Despite a primary benefit, resistance to the 3rd generation EGFR-Tyrosine Kinase Inhibitor (TKI) osimertinib invariably occurs. Several reports have recently highlighted the emergence of new oncogenic alterations as an actionable mechanism of resistance. However, the question of whether those alterations occur within a single tumor cell or in distinct tumor cell populations is still pending. Understanding those mechanisms at a cellular level is essential for a better comprehension of acquired resistance mechanisms and to identify new therapeutic opportunities.
Methods This project studied tissues and patient derived cell lines from the ongoing prospective MATCH-R study (NCT0251782), in which patients with unresectable or metastatic cancer are included upon acquired resistance to targeted therapies or immunotherapy. Serial blood samples and tumor biopsies are collected at progression, for targeted NGS, WES and RNAseq, as well as PDX and patient-derived cell lines development. EGFR-mutated patients presenting a new driver alteration at osimertinib progression were identified. Single cell isolation and whole genome amplification were performed on corresponding frozen biopsies and derived cell lines. Cell lines were then exposed to specific inhibitors targeting the different pathways involved and functional analysis were performed to study the efficiency of combining different targeted therapies.
Results Out of 466 patients included in MATCH-R study since June 2015, 110 patients presented EGFR-mutated adenocarcinoma. Among the 38 patients who experienced progression to 2nd line osimertinib, 5 patients were identified with a new oncogenic driver alteration, including STRN-ALK fusion (n=1), FGFR3-TACC3 fusion (n=1), BRAFV600E mutation (n=2), KIF-RET fusion (n=1). One patient progressing to 1st line osimertinib was identified with FGFR3-TACC3 fusion. All samples presented the persistence of EGFR activating mutation, i.e. EGFR exon 19 deletion (n=4) and exon 21 L858R mutation (n=2). After single cell isolation from tissue biopsies, PCR and targeted NGS allowed to highlight the co-existence of both drivers within single tumor cells for three patients. The remaining samples are still under investigation. Combination strategies with dual TKI are currently ongoing in order to restore sensitivity in cell lines (IC50 and Western Blots).
Perspectives These data allow a better understanding of mechanisms underlying cell adaptation to EGFR-driven tumor inhibition. Combining targeted therapies represents a valuable therapeutic opportunity to overcome drug resistance in EGFR-mutated lung cancer. Updated results will be presented at the Meeting.
Citation Format: Jeanne Chen, Floriane Braye, Francesco Facchinetti, Ludovic Lacroix, Jean-Yves Scoazec, Lambros Tselikas, David Planchard, Laura Mezquita, Anas Gazzah, Charles Naltet, Pernelle Lavaud, Aline Maillard, Stefan Michiels, Christophe Massard, Ken.A. Olaussen, Fabrice André, Gilles Vassal, Jean-Charles Soria, Benjamin Besse, Luc Friboulet. Characterization of multiple driver alterations in acquired resistance to osimertinib in EGFR-mutated lung cancer: implementation of single cell approaches [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1867.
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Recondo G, Mezquita L. Clinical efficacy, predictive biomarkers and response patterns of immunotherapy combinations for patients with cancer. Future Oncol 2020; 16:1659-1664. [PMID: 32783513 DOI: 10.2217/fon-2020-0707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Chic N, Mezquita L, Aldea M, Chebib R, Caramella C, Planchard D, Besse B. Successful Switch to Vemurafenib Plus Cobimetinib After Dabrafenib Plus Trametinib Toxicity in BRAF V600E-Mutant Metastatic Non-Small-Cell Lung Cancer. Clin Lung Cancer 2020; 22:e54-e56. [PMID: 32896487 DOI: 10.1016/j.cllc.2020.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/04/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
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Riudavets M, Auclin E, Mezquita L. Host circulating biomarkers for immune-checkpoint inhibitors: single-agent and combinations. Future Oncol 2020; 16:1665-1668. [PMID: 32422071 DOI: 10.2217/fon-2020-0182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Aldea M, Benitez JC, Mezquita L. The Lung Immune Prognostic Index (LIPI) stratifies prognostic groups in advanced non-small cell lung cancer (NSCLC) patients. Transl Lung Cancer Res 2020; 9:967-970. [PMID: 32953477 PMCID: PMC7481630 DOI: 10.21037/tlcr.2020.04.14] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Botticella A, Mezquita L, Le Pechoux C, Planchard D. Durvalumab for stage III non-small-cell lung cancer patients: clinical evidence and real-world experience. Ther Adv Respir Dis 2020; 13:1753466619885530. [PMID: 31686616 PMCID: PMC6831969 DOI: 10.1177/1753466619885530] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Stage III non-small cell lung cancer (NSCLC) has a dismal prognosis, with only
15–20% of patients alive at 5 years after concomitant chemo–radiotherapy, which
represents the standard treatment. Targeting immune-checkpoint inhibitors
represents a standard option for advanced NSCLC. Improvements in understanding
of the immune profile of NSCLC has led to the development of immunotherapeutic
strategies, including inhibitory molecules responsible for abrogating an
anticancer immune response such as programmed cell-death 1 and programmed
cell-death ligand 1. A recently published phase III trial (PACIFIC) showed for
the first time an improved overall survival in stage III NSCLC patients with
consolidative durvalumab. The aim of this review is to summarize and discuss the clinical evidence for the
use of durvalumab in stage III NSCLC, with a brief overview on future
perspectives in this setting.
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Remon J, Swalduz A, Planchard D, Ortiz-Cuaran S, Mezquita L, Lacroix L, Jovelet C, Rouleau E, Leonce C, De Kievit F, Morris C, Jones G, Mercier K, Howarth K, Green E, Pérol M, Saintigny P, Besse B. Outcomes in oncogenic-addicted advanced NSCLC patients with actionable mutations identified by liquid biopsy genomic profiling using a tagged amplicon-based NGS assay. PLoS One 2020; 15:e0234302. [PMID: 32525942 PMCID: PMC7289417 DOI: 10.1371/journal.pone.0234302] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 05/22/2020] [Indexed: 11/19/2022] Open
Abstract
Circulating tumor DNA (ctDNA)-based molecular profiling is rapidly gaining traction in clinical practice of advanced cancer patients with multi-gene next-generation sequencing (NGS) panels. However, clinical outcomes remain poorly described and deserve further validation with personalized treatment of patients with genomic alterations detected in plasma ctDNA. Here, we describe the outcomes, disease control rate (DCR) at 3 months and progression-free survival (PFS) in oncogenic-addicted advanced NSCLC patients with actionable alterations identified in plasma by ctDNA liquid biopsy assay, InVisionFirst®-Lung. A pooled retrospective analysis was completed of 81 advanced NSCLC patients with all classes of alterations predicting response to current FDA approved drugs: sensitizing common EGFR mutations (78%, n = 63) with T790M (73%, 46/63), ALK / ROS1 gene fusions (17%, n = 14) and BRAF V600E mutations (5%, n = 4). Actionable driver alterations detected in liquid biopsy were confirmed by prior tissue genomic profiling in all patients, and all patients received personalized treatment. Of 82 patients treated with matched targeted therapies, 10% were at first-line, 41% at second-line, and 49% beyond second-line. Acquired T790M at TKI relapse was detected in 73% (46/63) of patients, and all prospective patients (34/46) initiated osimertinib treatment based on ctDNA results. The 3-month DCR was 86% in 81 evaluable patients. The median PFS was of 14.8 months (12.1–22.9m). Baseline ctDNA allelic fraction of genomic driver did not correlate with the response rate of personalized treatment (p = 0.29). ctDNA molecular profiling is an accurate and reliable tool for the detection of clinically relevant molecular alterations in advanced NSCLC patients. Clinical outcomes with targeted therapies endorse the use of liquid biopsy by amplicon-based NGS ctDNA analysis in first line and relapse testing for advanced NSCLC patients.
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Mazieres J, Drilon A, Lusque A, Mhanna L, Cortot AB, Mezquita L, Thai AA, Mascaux C, Couraud S, Veillon R, Van den Heuvel M, Neal J, Peled N, Früh M, Ng TL, Gounant V, Popat S, Diebold J, Sabari J, Zhu VW, Rothschild SI, Bironzo P, Martinez-Marti A, Curioni-Fontecedro A, Rosell R, Lattuca-Truc M, Wiesweg M, Besse B, Solomon B, Barlesi F, Schouten RD, Wakelee H, Camidge DR, Zalcman G, Novello S, Ou SI, Milia J, Gautschi O. Immune checkpoint inhibitors for patients with advanced lung cancer and oncogenic driver alterations: results from the IMMUNOTARGET registry. Ann Oncol 2020; 30:1321-1328. [PMID: 31125062 PMCID: PMC7389252 DOI: 10.1093/annonc/mdz167] [Citation(s) in RCA: 770] [Impact Index Per Article: 192.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Anti-PD1/PD-L1 directed immune checkpoint inhibitors (ICI) are widely used to treat patients with advanced non-small-cell lung cancer (NSCLC). The activity of ICI across NSCLC harboring oncogenic alterations is poorly characterized. The aim of our study was to address the efficacy of ICI in the context of oncogenic addiction. Patients and methods We conducted a retrospective study for patients receiving ICI monotherapy for advanced NSCLC with at least one oncogenic driver alteration. Anonymized data were evaluated for clinicopathologic characteristics and outcomes for ICI therapy: best response (RECIST 1.1), progression-free survival (PFS), and overall survival (OS) from ICI initiation. The primary end point was PFS under ICI. Secondary end points were best response (RECIST 1.1) and OS from ICI initiation. Results We studied 551 patients treated in 24 centers from 10 countries. The molecular alterations involved KRAS (n = 271), EGFR (n = 125), BRAF (n = 43), MET (n = 36), HER2 (n = 29), ALK (n = 23), RET (n = 16), ROS1 (n = 7), and multiple drivers (n = 1). Median age was 60 years, gender ratio was 1 : 1, never/former/current smokers were 28%/51%/21%, respectively, and the majority of tumors were adenocarcinoma. The objective response rate by driver alteration was: KRAS = 26%, BRAF = 24%, ROS1 = 17%, MET = 16%, EGFR = 12%, HER2 = 7%, RET = 6%, and ALK = 0%. In the entire cohort, median PFS was 2.8 months, OS 13.3 months, and the best response rate 19%. In a subgroup analysis, median PFS (in months) was 2.1 for EGFR, 3.2 for KRAS, 2.5 for ALK, 3.1 for BRAF, 2.5 for HER2, 2.1 for RET, and 3.4 for MET. In certain subgroups, PFS was positively associated with PD-L1 expression (KRAS, EGFR) and with smoking status (BRAF, HER2). Conclusions : ICI induced regression in some tumors with actionable driver alterations, but clinical activity was lower compared with the KRAS group and the lack of response in the ALK group was notable. Patients with actionable tumor alterations should receive targeted therapies and chemotherapy before considering immunotherapy as a single agent.
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Besse B, Dormieux A, Mezquita L, Monnet R, Tazdait M, Lacroix L, Rouleau E, Adam J, Remon Masip J, Bluthgen M, Facchinetti F, Tzelikas L, Lavaud P, Naltet C, Le Pechoux C, Balleyguier C, Planchard D, Lassau N, Cournede PH, Caramella C. Prediction of the molecular status in non-small cell lung cancer based on metastatic pattern: A free webtool powered by artificial intelligence. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9535 Background: Molecular characterization of metastatic lung adenocarcinomas is mandatory but might be hampered by the quantity of tissue, restricted access to molecular platforms or limited economical resources. Our aim was to develop a tool supported by the hypothesis that radiological patterns of pts could help predict the rate of positivity of the most common oncogenic drivers. Methods: We defined an algorithm based on a molecularly defined cohort of 656 pts with stage IV lung adenocarcinoma. Two radiologists centrally reviewed the baseline imaging. Clinical data were retrospectively collected. There were 135 EGFR mutations, 81 ALK fusions, 47 BRAF mutations, 141 KRAS mutations, and 146 pan-negative tumors for these 4 oncogenic drivers. Univariate correlation analyses were performed to define an algorithm predicting the molecular testing positivity based on the metastatic pattern. Subsequently, an online tool was developed. This study was approved by our institutional review board. Results: Metastatic patterns correlated with the genomic drivers when compared to the pan-negative group. In the EGFR group, pleural metastases were more frequent (32% vs. 20%; p = 0.021), whereas adrenal and node metastases less frequent (6% vs.23%; p < 0.001 and 11% vs. 23% respectively; p = 0.011). In the ALK group, there were more brain and lung metastases (respectively 42% vs. 29%; p = 0.043 and 37% vs. 24% respectively; p = 0.037). In the BRAF group, pleural and pericardial metastases were more common (47% vs. 20%; p < 0.001 and 11% vs. 3% respectively; p = 0.04) and bone metastases less common (21% vs. 42%; p = 0.011). Lymphangitis was more frequent in EGFR, ALK and BRAF groups (6%, 7% and 15% vs. 1%; p = 0,016, p = 0,009 and p < 0,001 respectively). A free online access to the algorithm is now available after registration at http//tactic-ct.fr. Physicians enter age, sex, smoking status and the sites of metastases at diagnosis (present/absent/unknown). A mutation score is calculated, reflecting the % of chance to find an oncogenic driver. On the website, contributors can also enter new cases and an artificial intelligence will refine the algorithm and expand the number of oncogenic drivers. Conclusions: Our free access tool allows establishing a hierarchy in the molecular testing based on simple clinical and radiological information. Continual learning from new cases entered in the database will increase the sensitivity of the tool. This tool might save time, tumor tissue, economical resources and accelerate access to personalized treatment.
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Gobbini E, Toffart AC, Pérol M, Assié JB, Duruisseaux M, Coupez D, Dubos C, Westeel V, Delaunay M, Guisier F, Veillon R, Gounant V, Giroux Leprieur E, Vanel FR, Chaabane N, Dansin E, Babey H, Decroisette C, Barlesi F, Daniel C, Fournel P, Mezquita L, Oulkhouir Y, Canellas A, Duchemann B, Molinier O, Alcazer V, Moro-Sibilot D, Levra MG. Immune Checkpoint Inhibitors Rechallenge Efficacy in Non-Small-Cell Lung Cancer Patients. Clin Lung Cancer 2020; 21:e497-e510. [PMID: 32605892 DOI: 10.1016/j.cllc.2020.04.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/26/2020] [Accepted: 04/23/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Immune checkpoint inhibitor (ICPi) rechallenge could represent an attractive option in non-small-cell lung cancer (NSCLC), yet no sufficient data supporting this strategy are available. This retrospective observational multicenter national study explored the efficacy of anti-programmed cell death 1 (PD-1)/programmed death ligand 1 (PD-L1) rechallenge in advanced NSCLC patients, looking for potential clinical features associated with greater outcomes. PATIENTS AND METHODS We retrospectively collected data from 144 advanced NSCLC patients whose disease was rechallenged with ICPis after ≥ 12 weeks of discontinuation. The progression-free survival (PFS) and overall survival (OS) were calculated from first or second ICPi initiation to disease progression (PFS1 and PFSR, respectively), death, or last follow-up (OS1, OSR), respectively. RESULTS The median (interquartile range) age was 63 (58-70) years. Most patients were male (67%) and smokers (87%). Most had adenocarcinomas (62%) and/or stage IV disease at diagnosis (66%). The best response at rechallenge was not associated with that under the first ICPi (P = 1.10-1). The median (95% confidence interval) PFS1 and PFSR were 13 (10-16.5) and 4.4 (3-6.5) months, respectively. The median (95% confidence interval) OS1 and OSR were 3.3 (2.9-3.9) and 1.5 (1.0-2.1) years, respectively. Longer PFSR and OSR were found in patients discontinuing first ICPi because of toxicity or clinical decision, those not receiving systemic treatment between the two ICPis, and those with good Eastern Cooperative Oncology Group performance status at rechallenge. Only performance status proved to affect outcomes at multivariate analysis. CONCLUSION Patients discontinuing first ICPi because of toxicity or clinical decision, those able to maintain a treatment-free period, and those with good performance status may be potential candidates for rechallenge.
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Dormieux A, Mezquita L, Cournede PH, Remon J, Tazdait M, Lacroix L, Rouleau E, Adam J, Bluthgen MV, Facchinetti F, Tselikas L, Aboubakar F, Naltet C, Lavaud P, Gazzah A, Le Pechoux C, Lassau N, Balleyguier C, Planchard D, Besse B, Caramella C. Association of metastatic pattern and molecular status in stage IV non-small cell lung cancer adenocarcinoma. Eur Radiol 2020; 30:5021-5028. [PMID: 32323012 DOI: 10.1007/s00330-020-06784-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 02/02/2020] [Accepted: 02/28/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The aim of our study was to investigate the association between driver oncogene alterations and metastatic patterns on imaging assessment, in a large cohort of metastatic lung adenocarcinoma patients. METHODS From January 2010 to May 2017, 550 patients with stage IV lung adenocarcinoma with molecular analysis were studied retrospectively including 135 EGFR-mutated, 81 ALK-rearrangement, 47 BRAF-mutated, 141 KRAS-mutated, and 146 negative tumors for these 4 mutations (4N). After review of the complete imaging report by two radiologists (junior and senior) to identify metastatic sites, univariate correlation analyzes were performed. RESULTS We found differences in metastatic tropism depending on the molecular alteration type when compared with the non-mutated 4N group: in the EGFR group, pleural metastases were more frequent (32% versus 20%; p = 0.021), and adrenal and node metastases less common (6% versus 23%; p < 0.001 and 11% versus 23%; p = 0.011). In the ALK group, there were more brain and lung metastases (respectively 42% versus 29%; p = 0.043 and 37% versus 24%; p = 0.037). In the BRAF group, pleural and pericardial metastases were more common (respectively 47% versus 20%; p < 0.001 and 11% versus 3%; p = 0.04) and bone metastases were rarer (21% versus 42%; p = 0.011). Lymphangitis was more frequent in EGFR, ALK, and BRAF groups (respectively 6%, 7%, and 15% versus 1%); p = 0.016; p = 0.009; and p < 0.001. CONCLUSION The application of these correlations between molecular status and metastatic tropism in clinical practice may lead to earlier and more accurate identification of patients for targeted therapy. KEY POINTS • Bone and brain metastasis are the most common organs involved in lung adenocarcinoma but the relative incidence of each metastatic site depends on the molecular alteration. • EGFR-mutated tumors preferentially spread to the pleura and less commonly to adrenals, ALK-rearrangement tumors usually spread to the brain and the lungs, whereas BRAF-mutated tumors are unlikely to spread to bones and have a serous (pericardial ad pleural) tropism. • These correlations could help in the clinical management of patients with metastatic lung adenocarcinoma.
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Mezquita L, Auclin E, Besse B. Letter to the Editor about Sorich et al. J Thorac Oncol 2020; 14:e209. [PMID: 31445741 DOI: 10.1016/j.jtho.2019.05.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 05/21/2019] [Indexed: 11/17/2022]
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Mezquita L, Swalduz A, Jovelet C, Ortiz-Cuaran S, Howarth K, Planchard D, Avrillon V, Recondo G, Marteau S, Benitez JC, De Kievit F, Plagnol V, Lacroix L, Odier L, Rouleau E, Fournel P, Caramella C, Tissot C, Adam J, Woodhouse S, Nicotra C, Auclin E, Remon J, Morris C, Green E, Massard C, Pérol M, Friboulet L, Besse B, Saintigny P. Clinical Relevance of an Amplicon-Based Liquid Biopsy for Detecting ALK and ROS1 Fusion and Resistance Mutations in Patients With Non-Small-Cell Lung Cancer. JCO Precis Oncol 2020; 4:PO.19.00281. [PMID: 32923908 PMCID: PMC7448797 DOI: 10.1200/po.19.00281] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Liquid biopsy specimen genomic profiling is integrated in non-small-cell lung cancer (NSCLC) guidelines; however, data on the clinical relevance for ALK /ROS1 alterations are scarce. We evaluated the clinical utility of a targeted amplicon-based assay in a large prospective cohort of patients with ALK/ROS1-positive NSCLC and its impact on outcomes. PATIENTS AND METHODS Patients with advanced ALK/ROS1-positive NSCLC were prospectively enrolled in the study by researchers at eight French institutions. Plasma samples were analyzed using InVisionFirst-Lung and correlated with clinical outcomes. RESULTS Of the 128 patients included in the study, 101 were positive for ALK and 27 for ROS1 alterations. Blood samples (N = 405) were collected from 29 patients naïve for treatment with tyrosine kinase inhibitors (TKI) or from 375 patients under treatment, including 105 samples collected at disease progression (PD). Sensitivity was 67% (n = 18 of 27) for ALK/ROS1 fusion detection. Higher detection was observed for ALK fusions at TKI failure (n = 33 of 74; 46%) versus in patients with therapeutic response (n = 12 of 109; 11%). ALK-resistance mutations were detected in 22% patients (n = 16 of 74) overall; 43% of the total ALK-resistance mutations identified occurred after next-generation TKI therapy. ALK G1202R was the most common mutation detected (n = 7 of 16). Heterogeneity of resistance was observed. ROS1 G2032R resistance was detected in 30% (n = 3 of 10). The absence of circulating tumor DNA mutations at TKI failure was associated with prolonged median overall survival (105.7 months). Complex ALK-resistance mutations correlated with poor overall survival (median, 26.9 months v NR for single mutation; P = .003) and progression-free survival to subsequent therapy (median 1.7 v 6.3 months; P = .003). CONCLUSION Next-generation, targeted, amplicon-based sequencing for liquid biopsy specimen profiling provides clinically relevant detection of ALK/ROS1 fusions in TKI-naïve patients and allows for the identification of resistance mutations in patients treated with TKIs. Liquid biopsy specimens from patients treated with TKIs may affect clinical outcomes and capture heterogeneity of TKI resistance, supporting their role in selecting sequential therapy.
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Mezquita L, Jové M, Nadal E, Kfoury M, Morán T, Ricordel C, Dhooge M, Tlemsani C, Léna H, Teulé A, Álvarez JV, Raimbourg J, Hiret S, Lacroix L, Menéndez M, Saldaña J, Brunet J, Lianes P, Coupier I, Auclin E, Recondo G, Friboulet L, Adam J, Green E, Planchard D, Frébourg T, Capellà G, Rouleau E, Lázaro C, Caron O, Besse B. High Prevalence of Somatic Oncogenic Driver Alterations in Patients With NSCLC and Li-Fraumeni Syndrome. J Thorac Oncol 2020; 15:1232-1239. [PMID: 32179180 DOI: 10.1016/j.jtho.2020.03.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Actionable somatic molecular alterations are found in 15% to 20% of NSCLC in Europe. NSCLC is a tumor observed in patients with germline TP53 variants causing Li-Fraumeni syndrome (LFS), but its somatic molecular profile is unknown. METHODS Retrospective study of clinical and molecular profiles of patients with NSCLC and germline TP53 variants. RESULTS Among 22 patients with NSCLC and LFS (n = 23 lung tumors), 64% were women, median age was 51 years, 84% were nonsmokers, 73% had adenocarcinoma histological subtype, and 84% were diagnosed with advanced-stage disease. These patients harbored 16 distinct germline TP53 variants; the most common was p.R158H (5/22; three in the same family). Personal and family histories of cancer were reported in 71% and 90% of patients, respectively. In most cases (87%, 13/15), lung cancer was diagnosed with a late onset. Of the 21 tumors analyzed, somatic oncogenic driver mutations were found in 19 of 21 (90%), EGFR mutations in 18 (exon 19 deletion in 12 cases, L858R in three cases, and G719A, exon 20 insertion, and missing mutation subtype, each with one case), and ROS1 fusion in one case. A PI3KCA mutation was concurrently detected at diagnosis in three EGFR exon 19-deleted tumors (3/12). The median overall survival was 37.3 months in 14 patients treated with EGFR inhibitors; seven developed resistance, five (71%) acquired EGFR-T790M mutation, and one had SCLC transformation. CONCLUSIONS Driver oncogenic alterations were observed in 90% of the LFS tumors, mainly EGFR mutations; one ROS1 fusion was also observed. The germline TP53 variants and lung cancer carcinogenesis driven by oncogenic processes need further evaluation.
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Remon J, Passiglia F, Ahn MJ, Barlesi F, Forde PM, Garon EB, Gettinger S, Goldberg SB, Herbst RS, Horn L, Kubota K, Lu S, Mezquita L, Paz-Ares L, Popat S, Schalper KA, Skoulidis F, Reck M, Adjei AA, Scagliotti GV. Immune Checkpoint Inhibitors in Thoracic Malignancies: Review of the Existing Evidence by an IASLC Expert Panel and Recommendations. J Thorac Oncol 2020; 15:914-947. [PMID: 32179179 DOI: 10.1016/j.jtho.2020.03.006] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/29/2020] [Accepted: 03/06/2020] [Indexed: 02/07/2023]
Abstract
In the past 10 years, a deeper understanding of the immune landscape of cancers, including immune evasion processes, has allowed the development of a new class of agents. The reactivation of host antitumor immune response offers the potential for long-term survival benefit in a portion of patients with thoracic malignancies. The advent of programmed cell death protein 1/programmed death ligand-1 immune checkpoint inhibitors (ICIs), both as single agents and in combination with chemotherapy, and more recently, the combination of ICI, anti-programmed cell death protein 1, and anticytotoxic T-lymphocyte antigen 4 antibody, have led to breakthrough therapeutic advances for patients with advanced NSCLC, and to a lesser extent, patients with SCLC. Encouraging activity has recently emerged in pretreated patients with thymic carcinoma (TC). Conversely, in malignant pleural mesothelioma, pivotal positive signs of activity have not been fully confirmed in randomized trials. The additive effects of chemoradiation and immunotherapy suggested intriguing potential for therapeutic synergy with combination strategies. This has led to the introduction of ICI consolidation therapy in stage III NSCLC, creating a platform for future therapeutic developments in earlier-stage disease. Despite the definitive clinical benefit observed with ICI, primary and acquired resistance represent well-known biological phenomena, which may affect the therapeutic efficacy of these agents. The development of innovative strategies to overcome ICI resistance, standardization of new patterns of ICI progression, identification of predictive biomarkers of response, optimal treatment duration, and characterization of ICI efficacy in special populations, represent crucial issues to be adequately addressed, with the aim of improving the therapeutic benefit of ICI in patients with thoracic malignancies. In this article, an international panel of experts in the field of thoracic malignancies discussed these topics, evaluating currently available scientific evidence, with the final aim of providing clinical recommendations, which may guide oncologists in their current practice and elucidate future treatment strategies and research priorities.
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Enrico D, Lacroix L, Chen J, Rouleau E, Scoazec JY, Loriot Y, Tselikas L, Jovelet C, Planchard D, Gazzah A, Mezquita L, Ngo-Camus M, Michiels S, Massard C, Recondo G, Facchinetti F, Remon J, Soria JC, André F, Vassal G, Friboulet L, Besse B. Oncogenic Fusions May Be Frequently Present at Resistance of EGFR Tyrosine Kinase Inhibitors in Patients With NSCLC: A Brief Report. JTO Clin Res Rep 2020; 1:100023. [PMID: 34589930 PMCID: PMC8474286 DOI: 10.1016/j.jtocrr.2020.100023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Despite initial benefit, virtually all patients suffering from EGFR-mutant NSCLC experience acquired resistance to tyrosine kinase inhibitors (TKIs), driven by multiple mechanisms. Recent reports have identified oncogenic kinase fusions as off-target resistance mechanisms; however, these alterations have been rarely investigated at EGFR TKIs progression. Methods Patients with EGFR-mutated metastatic NSCLC (N = 62) with tissue and plasma biopsies at EGFR TKI progression between January 2015 and June 2019, at a French hospital and optionally before progression, were identified from the prospective MATCH-R study (NCT02517892). Postprogression biopsy samples were analyzed for gene fusions using targeted gene panel sequencing, whole-exome sequencing, RNA sequencing, and comparative genomic hybridization array. Results Six gene fusions were detected in tumor progression biopsies under an EGFR TKI from 62 consecutive patients (9.7%) with EGFR-mutated advanced NSCLC. Among 31 patients progressing to first- or second-generation EGFR TKIs, one (3%) had an Eukaryotic translation initiation factor 4 gamma 2–GRB2 associated binding protein 1 (EIF4G2-GAB1) fusion. Among 31 patients progressing to the third-generation osimertinib, five (16%) presented oncogene fusions of fibroblast growth factor receptor 3–transforming acidic coiled-coil containing protein 3 (FGFR3-TACC3) (n = 2), kinesin family member 5B–Ret proto-oncogene (KIF5B-RET) (n = 1), striatin–anaplastic lymphoma kinase (STRN-ALK) (n = 1), and zinc finger DHHC-Type palmitoyltransferase 20–Thr790Met (ZDHHC20-BRAF) (n = 1) transcripts. Out of two patients that received osimertinib at first-line, one acquired an FGFR3-TACC3 fusion at progression. In all patients, fusions co-occurred with the original activating EGFR mutation; however, among four patients with an acquired T790M mutation, three (75%) lost the T790M mutation. Conclusions Oncogenic fusions at the time of EGFR TKI resistance were identified at a relatively high frequency, mainly after the third-generation TKI osimertinib. Patients progressing to EGFR TKIs may have a new opportunity for targeted therapy when oncogenic fusions are identified.
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Baldini C, Martin Romano P, Voisin AL, Danlos FX, Champiat S, Laghouati S, Kfoury M, Vincent H, Postel-Vinay S, Varga A, Vuagnat P, Ribrag V, Mezquita L, Besse B, Hollebecque A, Lambotte O, Michot JM, Soria JC, Massard C, Marabelle A. Impact of aging on immune-related adverse events generated by anti-programmed death (ligand)PD-(L)1 therapies. Eur J Cancer 2020; 129:71-79. [PMID: 32143106 DOI: 10.1016/j.ejca.2020.01.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/21/2020] [Accepted: 01/28/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Aging is an important risk factor for cancers and is associated with poor prognosis. Weakness of the immune system, also called immunosenescence may occur with older age. The impact of aging on efficacy and safety of immune checkpoint blockers, such as anti-programmed death (ligand) PD-(L)1, remains undetermined. This study aims to evaluate the incidence of immune-related adverse events (irAEs) in patients aged 70 years or older than their younger counterparts. METHODS Patients with advanced solid tumors treated at Gustave Roussy with an anti-PD-(L)1 monotherapy between June 2014 and October 2017 were prospectively included within the dedicated irAEs pharmacovigilance registry REISAMIC (Registre des Effets Indésirables Sévères des Anticorps Monoclonaux Immunomodulateurs en Cancérologie). The incidence of irAEs of grade ≥II was compared between patients aged ≥70 (old patients, OP) versus patients aged < 70 years (young patients, YP) using a chi-squared test. Survivals were estimated using the Kaplan-Meier method. RESULTS Among the 603 patients treated by anti-PD(L)1, 191 were ≥70 y.o (OP) and 424 < 70 y.o (YP). The median (range) age of OP and YP were respectively 77 (70-93) and 59 years old (17-69). A total of 165 irAEs occurred in these patients (103 grade II and 58 grade III-IV). The overall incidence of grade ≥II irAEs was higher in OP than in YP (33% versus 25%, p = 0.03). In addition, OP were more prone of having multiples irAEs compared with YP (p = 0.037). Skin toxicities were more frequent in OP than in YP (p = 0.007) but endocrine toxicities were less frequent in OP than in YP (p = 0.044). This higher level of irAEs seems to be responsible for a higher rate of treatment discontinuation in OP (p = 0.2). There was no statistical difference in median time to toxicity, exposure to steroids or survival between the two groups. CONCLUSION Although anti-PD-(L)1 immunotherapies remain an acceptable treatment option for older patients, prescribers should be aware that irAEs are more frequent in the elderly. Further translational studies are warranted to better understand the relationship between aging and irAEs.
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Benitez JC, Recondo G, Rassy E, Mezquita L. The LIPI score and inflammatory biomarkers for selection of patients with solid tumors treated with checkpoint inhibitors. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2020; 64:162-174. [PMID: 32107903 DOI: 10.23736/s1824-4785.20.03250-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Over the last decade, immune checkpoint inhibitors (ICI) have completely changed the treatment strategy and the prognosis of several solid cancer types. There is a lack of biomarkers to differ between responders and non-responders to these therapies. The development of biomarkers for immunotherapy has been mainly focused on tumor-related factors. The role of PD-L1 expression or tumor mutational burden (TMB) as potential predictive biomarkers for ICI efficacy is not universal and remains controversial. Moreover, leukocyte and neutrophil counts in blood samples have been used to develop clinical indicators of systemic inflammation like the neutrophil to lymphocyte ratio (NLR) and derived neutrophil to lymphocyte ratio (dNLR) based on the host immunologic status to respond against cancer cells by the immune-effectors. The Lung Immune Prognostic Index (LIPI) score have been developed as a reliable tool to assess the risk stratification of patients with cancer and to guide treatment decisions in the era of personalized cancer treatments. We review the clinical evidence supporting the use of the LIPI index as a clinically valuable biomarker for patients with NSCLC and other solid tumor types, treated with immunotherapy.
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Lavaud P, Dalban C, Negrier S, Chevreau C, Gravis G, Oudard S, Laguerre B, Barthelemy P, Borchiellini D, Gross Goupil M, Geoffrois L, Rolland F, Thiery-Vuillemin A, Joly F, Ladoire S, Tantot F, Mezquita L, Escudier B, Albiges L. Validation of the lung immune prognostic index (LIPI) in patients with metastatic renal cell carcinoma treated with nivolumab in the GETUG-AFU 26 NIVOREN trial. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.735] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
735 Background: The Lung Immune Prognostic Index (LIPI) is a prognostic score combining pretreatment dNLR (neutrophils/ (leucocytes-neutrophils) and LDH correlated to immune checkpoint inhibitors (ICI) benefit in several advanced cancers. We aimed to correlate LIPI score with Nivolumab (N) benefit in metastatic clear cell renal cell carcinoma (mccRCC) patients. Methods: We investigated the LIPI score in the GETUG-AFU 26 NIVOREN phase II trial assessing the activity and safety of N after failure of upfront VEGF-targeted therapies. A dNLR ≥ 3 and LDH ≥ upper superior limit were analyzed for the LIPI, and patients were stratified into 3 groups (good (GG), intermediate (IG) and poor (PG)) (Mezquita et al, JAMA Oncol 2018). The primary endpoint was overall survival (OS), and secondary endpoints were progression-free survival (PFS) and objective response rate (ORR). Results: Overall, 619 pts were included. Median age was 64 years old, 22.1% pts had received more than 2 previous lines and IMDC risk groups were 18.3%, 56.5% and 25.0% for good/intermediate and poor risk respectively. Median (m) follow up was 23.7 months (mo). The mPFS with N was 4.0 mo and mOS was not reach. LIPI classified 364 pts (58.8%) as GG, 216 pts (34.9%) as IG and 39 pts (6.3%) as PG. The PFS and OS results are summarized in the Table. In multivariate analysis, LIPI score remains an independent prognostic factor after adjustment for sex, age, ECOG PS and IMDC. ORR did not seem to be influenced by the LIPI groups. Conclusions: We report for the first time that LIPI score is associated with PFS and OS in patients treated with N for mccRCC. LIPI score appears as an independent prognostic factor even after adjustment for established risk factors. External validation in a VEGF-targeted therapy cohort is ongoing and will contribute to evaluate the predictive value of LIPI in mccRCC.[Table: see text]
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Pauline P, Auclin E, Mezquita L, Chanza NM, Dumont C, Rodriguez-Vida A, Lozano R, Vera B, Ratta R, Baciarello G, Colomba E, Fuerea A, Besse B, Loriot Y, Lavaud P. Association of the Lung Immune Prognostic Index with outcome in patients with metastatic urothelial cancer treated with immune checkpoint inhibitor. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
545 Background: Prognostic factors for survival in metastatic urothelial carcinoma (mUC) have been reported in patients (pts) treated with chemotherapy (Bellmunt and al, JCO 2010). However, no biomarkers have been clearly identified in the setting of immune-checkpoint inhibitors (ICI). The Lung immune prognostic index (LIPI) was associated with clinical outcomes for ICI in lung cancer (Mezquita et al, Jama Oncol 2018) and other tumor types (Varga et al, TAT 2019). In this multicenter retrospective study, we correlated LIPI with outcomes in pts with mUC treated with ICI. Methods: Pts with mUC enrolled from May 2013 to July 2018 in 7 high volume centers were analysed. LIPI score includes: LDH > upper limit of normal and neutrophil/[leukocytes minus neutrophils] ratio (dNLR) > 3. The following LIPI subgroups were defined: good prognosis (0), intermediate prognosis (1) and poor prognosis (2 factors). Median (m) progression-free survival (PFS) and median overall survival (OS) were calculated using Kaplan-Meier method, log rank test was used for statistical comparison. Cox model was used for multivariate analysis. Results: To date, 152 mUC pts have been enrolled and preliminary analysis have been performed in 135 pts. Median age was 67 years, 111 (82%) pts were male, 106 pts (79%) had ECOG PS 0-1, 31 pts (23%) had liver metastasis. Median follow-up was 21.1 months (mo) (95% CI; 16.3-24.5), mPFS was 3.6 mo (95% CI; 2.6-6.0) and mOS was 13.8 mo (95% CI; 11.5-23.2). LIPI classified the population in good (56%), intermediate (35%) and poor (9%) prognosis group. In multivariate analysis, estimated mPFS in good, intermediate and poor prognosis were 5.8 mo (95% CI; 2.6-6.0), 3.6 mo (95% CI; 3.3-16.2) and 1.2 mo (95% CI;0.1-NR), respectively (p = 0.001). Estimated mOS in good, intermediate and poor prognosis were 17.3 mo (95% CI; 13.0-36.8), 16.9 mo (95% CI; 6.9-NR) and 5.4 mo (95% CI;2.5-NR), respectively (p = 0.19). OS data will be validated on larger cohort. Conclusions: The LIPI score is associated with clinical outcome to ICI and may be a useful tool for identifying patients who may not benefit from ICI. Validation in independent prospective cohort is ongoing.
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Baraibar I, Mezquita L, Gil-Bazo I, Planchard D. Novel drugs targeting EGFR and HER2 exon 20 mutations in metastatic NSCLC. Crit Rev Oncol Hematol 2020; 148:102906. [PMID: 32109716 DOI: 10.1016/j.critrevonc.2020.102906] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 02/03/2023] Open
Abstract
Approximately 4% of epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) present EGFR exon 20 in-frame insertions, accounting for 0.3 %-3.7 % of NSCLC. In addition, 2 %-4 % of patients with NSCLC harbor human epidermal growth factor receptor 2 gene (HER2) mutations, being the 90 % of them exon 20 insertions. These mutations confer intrinsic resistance to available EGFR tyrosine kinase inhibitors (TKIs) and anti-HER2 treatments, as they result in steric hindrance of the drug-binding pocket. Therefore, no targeted therapies have been approved for NSCLC patients with EGFR or HER2 exon 20- activating mutations to date and remain an unmet clinical need. Promising efforts to novel treatment development have been made. Early data provide encouraging activity of novel drugs targeting EGFR and HER2 mutations in metastatic NSCLC. In this review we will summarize all the data reported to date about these driver molecular alterations and potential targeted therapies.
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Ortet G, Pinazo D, Walker D, Gallego S, Mezquita L, Ibáñez MI. Personality and nonjudging make you happier: Contribution of the Five-Factor Model, mindfulness facets and a mindfulness intervention to subjective well-being. PLoS One 2020; 15:e0228655. [PMID: 32017791 PMCID: PMC6999907 DOI: 10.1371/journal.pone.0228655] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/21/2020] [Indexed: 12/18/2022] Open
Abstract
Mindful individuals are able to acknowledge mind wandering and live in the present moment in a nonjudgmental way. Previous studies have found that both mind wandering and mindfulness are associated with subjective well-being. However, the main predictor of happiness is personality; more specifically, happier people are emotionally stable and extraverted. The present study aimed to explore the contribution of the five factors of personality, dispositional mindfulness facets and a mindfulness intervention to happiness. A sample of 372 university students was assessed with the NEO-Five Factor Inventory, and another sample of 217 community adults answered the Big Five Personality Trait Short Questionnaire. Both samples, 589 participants in all, completed the Five Facet Mindfulness Questionnaire and the Subjective Happiness Scale. Furthermore, 55 participants from the general population sample took a 6-week training course in meditation and developing mindfulness. The regression analyses showed that emotional stability and extraversion traits were the strongest predictors of subjective well-being. Nonetheless, the nonjudging facet, which is nonevaluative/acceptance awareness of thoughts and feelings, still remained a significant predictor of happiness when personality was accounted for. Finally, mindfulness training did not increase subjective well-being. Being nonjudgmental of one's inner thoughts, feelings and sensations contributes to happiness even when personality is taken into account. Accordingly, it seems reasonable that mindfulness training that intends to improve subjective well-being should focus on noticing thoughts without judging them.
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Mezquita L, Bravo AJ, Morizot J, Pilatti A, Pearson MR, Ibáñez MI, Ortet G, Cross-Cultural Addictions Study Team. Cross-cultural examination of the Big Five Personality Trait Short Questionnaire: Measurement invariance testing and associations with mental health. PLoS One 2019; 14:e0226223. [PMID: 31846470 PMCID: PMC6917272 DOI: 10.1371/journal.pone.0226223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 11/21/2019] [Indexed: 11/18/2022] Open
Abstract
The present study examined the measurement invariance of the Big Five Personality Trait Short Questionnaire (BFPTSQ) across language (Spanish and English), Spanish-speaking country of origin (Argentina and Spain) and gender groups (female and male). Evidence of criterion-related validity was examined via associations (i.e., correlations) between the BFPTSQ domains and a wide variety of mental health outcomes. College students (n = 2158) from the USA (n = 1117 [63.21% female]), Argentina (n = 353 [65.72% female]) and Spain (n = 688 [66.86% female]) completed an online survey. Of the tested models, an Exploratory Structural Equation Model (ESEM) fit the data best. Multigroup ESEM and ESEM-within-CFA generally supported the measurement invariance of the questionnaire across groups. Internalizing symptomatology, rumination and low happiness were related mainly to low emotional stability across countries, while low agreeableness and low conscientiousness were related chiefly to externalizing symptomology (i.e., antisocial behavior and drug outcomes). Some correlational differences arose across countries and are discussed. Our findings generally support the BFPTSQ as an adequate measure to assess the Big Five personality domains in Spanish- and English-speaking young adults.
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Vuagnat P, Auclin E, Mezquita L, Alfonso JA, Tocino MV, Munoz FL, El Dakdouki Y, Romano PM, Baldini C, Varga A, Garcia-Carbonero R, Besse B, Massard C, Hollebecque A. Applicability of the LIPI score to metastatic microsatellite instability high cancer patients treated with immune checkpoint inhibitors. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz449.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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De Giglio A, Mezquita L, Auclin E, Blanc-Durand F, El-Amarti L, Caramella C, Bernal GM, Hendriks L, Ferrara R, Naltet C, Lavaud P, Gazzah A, Adam J, Planchard D, Chaput N, Besse B. Impact of early introduction of steroid on immune-checkpoint inhibitors (ICI) in patients with advanced non-small cell lung cancer treated. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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140
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Blanc-Durand F, Auclin E, Planchard D, Aix SP, Hendriks L, Sullivan I, Saravia D, Routy B, Castro RL, Pilotto S, Aboubakar F, Kassouf E, Rodriguez A, Martin AA, Bluthgen M, Duchemann B, Caramella C, Nadal E, Besse B, Mezquita L. Association of lung immune prognostic index (LIPI) with survival of first line immune checkpoint inhibitors single agent or in combination with chemotherapy in untreated advanced NSCLC patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz447.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Park W, Mezquita L, Okabe N, Chae YK, Kwon D, Saravia D, Auclin E, Planchard D, Caramella C, Ferrara R, Agte S, Oh M, Mudad R, Jahanzeb M, Suzuki H, Besse B, Lopes G. Association of the prognostic model iSEND with PD-1/L1 monotherapy outcome in non-small-cell lung cancer. Br J Cancer 2019; 122:340-347. [PMID: 31761899 PMCID: PMC7000664 DOI: 10.1038/s41416-019-0643-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 09/23/2019] [Accepted: 10/29/2019] [Indexed: 12/18/2022] Open
Abstract
Background Accessible biomarkers are needed for immunotherapy in advanced non-small-cell lung cancer (NSCLC). We previously described a multivariate risk prediction model, the iSEND, which categorises advanced NSCLC patients treated with nivolumab into Good, Intermediate or Poor groups. This model was developed by using only clinical and analytical variables (sex, ECOG-performance status, neutrophil-to-lymphocyte ratio [NLR] and post-treatment delta NLR). Methods An international database of 439 patients who received post-platinum PD-1/L1 monotherapies was collected for validation. Performance of the iSEND to different PD-L1 groups was compared by using time-dependent positive predictive value (PPV) for their mortality events. Results Median follow-up was 18.2 months (95% CI: 15.9–19.6). The overall survival of the iSEND Good (HR = 0.31, 95% CI: 0.22–0.43, p < 0.0001) was superior to the iSEND Poor. Time-dependent PPV for mortality of iSEND Poor was superior to PD-L1 = 0% group at 12 (75 vs. 53%, p = 0.01) and 18 months (85 vs. 46%, p = 0.03). However, female gender did not independently associate with better outcome in the validation cohort. Conclusion The iSEND model is associated with the outcome of post-platinum PD-1/L1 monotherapy in advanced NSCLC patients. The iSEND Poor demonstrated a superior performance to PD-L1 = 0% in negative prognostication. Prospective investigation and modelling with other significant parameters in a larger cohort are warranted.
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Enrico D, Lacroix L, Rouleau E, Scoazec JY, Loriot Y, Tselikas L, Jovelet C, Planchard D, Gazzah A, Mezquita L, Ngo M, Michiels S, Maillard A, Massard C, Facchinetti F, Soria JC, André F, Vassal G, Friboulet L, Besse B. A combination of resistance mechanisms is frequent in non-small cell lung cancer (NSCLC) that progressed to EGFR tyrosine kinase inhibitors (TKIs). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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143
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Dormieux A, Mezquita L, Cournede PH, Lacroix L, Rouleau E, Adam J, Facchinetti F, Aboubakar F, Bluthgen MV, Naltet C, Lavaud P, Gazzah A, Le Pechoux C, Balleyguier C, Planchard D, Besse B, Caramella C. Association of metastatic pattern and molecular status in metastatic lung non-small cell lung cancer adenocarcinomas. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mezquita L, Planchard D, Suarez MD, Aldea M, Naltet C, Lamberts V, Grecea M, Martin-Romano P, de Kievit F, Jovelet C, Lacroix L, Masip JR, Lavaud P, Gazzah A, Morris C, Howarth K, Green E, Vassal G, Massard C, Besse B. Clinical utility of ctDNA genomic alterations (GA) based on ESMO scale for clinical actionability of molecular targets (ESCAT) in advanced NSCLC. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz431.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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145
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Mezquita L, Planchard D, Dorta M, Aldea M, Naltet C, Lamberts V, Grecea AM, Martin-Romano P, De Kievit F, Jovelet C, Rouleau E, Lacroix L, Remon J, Lavaud P, Gazzah A, Morris C, Howarth K, Green E, Massard C, Besse B. OA03.08 Clinical Utility of CTDNA Driver Genomic Alterations (GA) Directing Targeted Therapy in Untreated Advanced NSCLC Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bravo AJ, Sotelo M, Pilatti A, Mezquita L, Read JP. Depressive symptoms, ruminative thinking, marijuana use motives, and marijuana outcomes: A multiple mediation model among college students in five countries. Drug Alcohol Depend 2019; 204:107558. [PMID: 31586807 PMCID: PMC6878192 DOI: 10.1016/j.drugalcdep.2019.107558] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/19/2019] [Accepted: 07/14/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies have evidenced that rumination and drinking motives may mediate the association between depressive symptoms and alcohol outcomes. The present study cross-culturally examined whether a similar mediation model may extend to marijuana. Specifically, we tested distinct rumination facets (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) and marijuana use motives (social, coping, expansion, conformity, enhancement) as double-mediators of the paths from depressive symptoms to marijuana outcomes (use and consequences). METHOD A comprehensive mediation path model was tested in a cross-sectional sample of college student marijuana users (n = 1175) from five countries (U.S., Argentina, Uruguay, Spain, Netherlands). Multi-group models were tested to determine if the proposed mediational model was invariant across sex and different cultures/countries. RESULTS Depressive symptoms and marijuana outcomes were indirectly associated through ruminative thinking and marijuana motives. Specifically, higher depressive symptoms were associated with higher problem-focused thoughts; which in turn were associated with: a) higher endorsement of coping motives which in turn was associated with higher marijuana use and related consequences and b) lower endorsement of enhancement motives which in turn was associated with lower marijuana use and related consequences. The multi-group analyses showed that the model was invariant across sex and the five countries. CONCLUSIONS The present research supports the existence of a universal (i.e., cross-national invariant) negative affect regulation pathway to marijuana use/misuse similar to those previously found with alcohol. Additional research is needed to confirm the role of enhancement motives in the associations of depression, rumination and marijuana outcomes.
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Bravo AJ, Pearson MR, Pilatti A, Mezquita L, Ibáñez MI, Ortet G. Ruminating in English, Ruminating in Spanish. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2019. [DOI: 10.1027/1015-5759/a000465] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The present study aimed to adapt and validate a Spanish version of the Ruminative Thought Style Questionnaire (RTSQ) and test for measurement invariance of the RTSQ across college students in the US, Spain, and Argentina ( n = 1,632). Additionally, we examined/compared across these countries, criterion-related (i.e., concurrent) validity of RTSQ factors (i.e., problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) on constructs theoretically-associated with rumination. Consistent with previous findings, we found that a 15-item 4-factor RTSQ provided a more adequate model compared to single-factor CFA models (15- and 20-item versions) in every country. The reliability and validity of the subscales for the Spanish version were satisfactory-to-good in Spain and Argentina. Using multigroup confirmatory factor analyses, we found the 15-item 4-factor version of the RTSQ to be invariant across countries and sex. Bivariate correlations provided evidence for the criterion-related validity of the 4-factor RTSQ across the countries. Our findings suggest that self-report items of the RTSQ convey the same meaning, and that responses to those items load onto the same set of factors, across languages and cultures of administration. Taken together, our findings serve as a foundation for future cross-cultural work testing models in which rumination is a central facet.
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Ferrara R, Mezquita L, Texier M, Lahmar J, Audigier-Valette C, Tessonnier L, Mazieres J, Zalcman G, Brosseau S, Le Moulec S, Leroy L, Duchemann B, Lefebvre C, Veillon R, Westeel V, Koscielny S, Champiat S, Ferté C, Planchard D, Remon J, Boucher ME, Gazzah A, Adam J, Bria E, Tortora G, Soria JC, Besse B, Caramella C. Hyperprogressive Disease in Patients With Advanced Non-Small Cell Lung Cancer Treated With PD-1/PD-L1 Inhibitors or With Single-Agent Chemotherapy. JAMA Oncol 2019; 4:1543-1552. [PMID: 30193240 DOI: 10.1001/jamaoncol.2018.3676] [Citation(s) in RCA: 490] [Impact Index Per Article: 98.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Hyperprogressive disease (HPD) is a new pattern of progression recently described in patients with cancer treated with programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors. The rate and outcome of HPD in advanced non-small cell lung cancer (NSCLC) are unknown. Objectives To investigate whether HPD is observed in patients with advanced NSCLC treated with PD-1/PD-L1 inhibitors compared with single-agent chemotherapy and whether there is an association between treatment and HPD. Design, Setting, and Participants In this multicenter retrospective study that included patients treated between August 4, 2011, and April 5, 2017, the setting was pretreated patients with advanced NSCLC who received PD-1/PD-L1 inhibitors (8 institutions) or single-agent chemotherapy (4 institutions) in France. Measurable disease defined by Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) on at least 2 computed tomographic scans before treatment and 1 computed tomographic scan during treatment was required. Interventions The tumor growth rate (TGR) before and during treatment and variation per month (ΔTGR) were calculated. Hyperprogressive disease was defined as disease progression at the first evaluation with ΔTGR exceeding 50%. Main Outcomes and Measures The primary end point was assessment of the HPD rate in patients treated with IO or chemotherapy. Results Among 406 eligible patients treated with PD-1/PD-L1 inhibitors (63.8% male), 46.3% (n = 188) were 65 years or older, 72.4% (n = 294) had nonsquamous histology, and 92.9% (n = 377) received a PD-1 inhibitor as monotherapy in second-line therapy or later. The median follow-up was 12.1 months (95% CI, 10.1-13.8 months), and the median overall survival (OS) was 13.4 months (95% CI, 10.2-17.0 months). Fifty-six patients (13.8%) were classified as having HPD. Pseudoprogression was observed in 4.7% (n = 19) of the population. Hyperprogressive disease was significantly associated with more than 2 metastatic sites before PD-1/PD-L1 inhibitors compared with non-HPD (62.5% [35 of 56] vs 42.6% [149 of 350]; P = .006). Patients experiencing HPD within the first 6 weeks of PD-1/PD-L1 inhibitor treatment had significantly lower OS compared with patients with progressive disease (median OS, 3.4 months [95% CI, 2.8-7.5 months] vs 6.2 months [95% CI, 5.3-7.9 months]; hazard ratio, 2.18 [95% CI, 1.29-3.69]; P = .003). Among 59 eligible patients treated with chemotherapy, 3 (5.1%) were classified as having HPD. Conclusions and Relevance Our study suggests that HPD is more common with PD-1/PD-L1 inhibitors compared with chemotherapy in pretreated patients with NSCLC and is also associated with high metastatic burden and poor prognosis in patients treated with PD-1/PD-L1 inhibitors. Additional studies are needed to determine the molecular mechanisms involved in HPD.
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149
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Recondo G, Mezquita L, Facchinetti F, Planchard D, Gazzah A, Bigot L, Rizvi AZ, Frias RL, Thiery JP, Scoazec JY, Sourisseau T, Howarth K, Deas O, Samofalova D, Galissant J, Tesson P, Braye F, Naltet C, Lavaud P, Mahjoubi L, Abou Lovergne A, Vassal G, Bahleda R, Hollebecque A, Nicotra C, Ngo-Camus M, Michiels S, Lacroix L, Richon C, Auger N, De Baere T, Tselikas L, Solary E, Angevin E, Eggermont AM, Andre F, Massard C, Olaussen KA, Soria JC, Besse B, Friboulet L. Diverse Resistance Mechanisms to the Third-Generation ALK Inhibitor Lorlatinib in ALK-Rearranged Lung Cancer. Clin Cancer Res 2019; 26:242-255. [PMID: 31585938 DOI: 10.1158/1078-0432.ccr-19-1104] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/01/2019] [Accepted: 09/30/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Lorlatinib is a third-generation anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor with proven efficacy in patients with ALK-rearranged lung cancer previously treated with first- and second-generation ALK inhibitors. Beside compound mutations in the ALK kinase domain, other resistance mechanisms driving lorlatinib resistance remain unknown. We aimed to characterize the mechanisms of resistance to lorlatinib occurring in patients with ALK-rearranged lung cancer and design new therapeutic strategies in this setting. EXPERIMENTAL DESIGN Resistance mechanisms were investigated in 5 patients resistant to lorlatinib. Longitudinal tumor biopsies were studied using high-throughput next-generation sequencing. Patient-derived models were developed to characterize the acquired resistance mechanisms, and Ba/F3 cell mutants were generated to study the effect of novel ALK compound mutations. Drug combinatory strategies were evaluated in vitro and in vivo to overcome lorlatinib resistance. RESULTS Diverse biological mechanisms leading to lorlatinib resistance were identified. Epithelial-mesenchymal transition (EMT) mediated resistance in two patient-derived cell lines and was susceptible to dual SRC and ALK inhibition. We characterized three ALK kinase domain compound mutations occurring in patients, L1196M/D1203N, F1174L/G1202R, and C1156Y/G1269A, with differential susceptibility to ALK inhibition by lorlatinib. We identified a novel bypass mechanism of resistance caused by NF2 loss-of-function mutations, conferring sensitivity to treatment with mTOR inhibitors. CONCLUSIONS This study shows that mechanisms of resistance to lorlatinib are diverse and complex, requiring new therapeutic strategies to tailor treatment upon disease progression.
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150
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Bravo AJ, Pearson MR, Pilatti A, Mezquita L. Negative marijuana-related consequences among college students in five countries: measurement invariance of the Brief Marijuana Consequences Questionnaire. Addiction 2019; 114:1854-1865. [PMID: 31066108 PMCID: PMC6732001 DOI: 10.1111/add.14646] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/01/2019] [Accepted: 04/27/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS The 21-item Brief Marijuana Consequences Questionnaire (B-MACQ) has been shown to be a valid measure to assess negative marijuana-related consequences among US college students. The present study aimed to: (a) examine measurement invariance of the B-MACQ among college student marijuana users in five countries, (b) evaluate latent mean differences on the B-MACQ as a function of sex and country if invariance is met and (c) compare criterion-related validity across different countries and sex. DESIGN Instrumental study. SETTING Argentina, the Netherlands, Spain, Uruguay and United States. PARTICIPANTS A subsample of last-month marijuana users who completed the B-MACQ (n = 1145; 62.9% female). MEASUREMENTS The B-MACQ, several dimensions of marijuana use and perceptions of marijuana use. FINDINGS Results supported configural and scalar invariance (all ΔCFI/TLI ≤ 0.01; ΔRMSEA ≤ 0.015) of a 20-item B-MACQ across sex and four countries (the Netherlands being the exception). In examining latent mean differences, Spanish students reported a higher number of consequences than US (P < 0.001) and Argentinian students (P = 0.003). In examining criterion-related validity, marijuana use indicators (0.01 < rs < 0.64), descriptive norms (0.04 < rs < 0.49) and injunctive norms for best friend (0.06 < rs < 0.28) largely had small-to-moderate positive correlations with negative marijuana-related consequences. CONCLUSIONS The 20-item B-MACQ accurately assesses marijuana-related negative consequences among male and female college student marijuana users across the United States, Argentina, Spain and Uruguay. The B-MACQ could be used effectively to identify marijuana-related consequences in college students from different countries or cultures.
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