KRAS p.G12C mutation occurs in 1% of EGFR-mutated advanced non-small-cell lung cancer patients progressing on a first-line treatment with a tyrosine kinase inhibitor.

BACKGROUND: KRAS is mutated in ∼30% of non-small-cell lung cancer (NSCLC) but it has also been identified as one of the mechanisms underlying resistance to tyrosine kinase inhibitors (TKIs) in EGFR-positive NSCLC patients. Novel KRAS inhibitors targeting KRAS p.G12C mutation have been developed recently with promising results. The proportion of EGFR-positive NSCLC tumours harbouring the KRAS p.G12C mutation upon disease progression is completely unexplored. MATERIALS AND METHODS: Plasma samples from 512 EGFR-positive advanced NSCLC patients progressing on a first first-line treatment with a TKI were collected. The presence of KRAS p.G12C mutation was assessed by digital PCR. RESULTS: Overall, KRAS p.G12C mutation was detected in 1.17% of the samples (n = 6). In two of these cases, we could confirm that the KRAS p.G12C mutation was not present in the pre-treatment plasma samples, supporting its role as an acquired resistance mutation. According to our data, KRASG12C patients showed similar clinicopathological characteristics to those of the rest of the study cohort and no statistically significant associations between any clinical features and the presence of the mutation were found. However, two out of six KRASG12C tumours harboured less common EGFR driver mutations (p.G719X/p.L861Q). All KRASG12C patients tested negative for the presence of p.T790M resistance mutation. CONCLUSIONS: The KRAS p.G12C mutation is detected in 1% of EGFR-positive NSCLC patients who progress on a first line with a TKI. All KRASG12C patients were negative for the presence of the p.T790M mutation and they did not show any distinctive clinical feature.

Validation of a Spanish language version of the pain self-perception scale in patients with fibromyalgia.

BACKGROUND: The Pain Self-Perception Scale (PSPS) is a 24-item questionnaire used to assess mental defeat in chronic pain patients. The aim of this study was to develop a Spanish language version of the PSPS (PSPS-Spanish), to assess the instrument's psychometric properties in a sample of patients with fibromyalgia and to confirm a possible overlapping between mental defeat and pain catastrophizing. METHODS: The PSPS was translated into Spanish by three bilingual content and linguistic experts, and then back-translated into English to assess for equivalence. The final Spanish version was administered, along with the Hospital Anxiety Depression Scale (HADS), Pain Visual Analogue Scale (PVAS), Pain Catastrophizing Scale (PCS) and Fibromyalgia Impact Questionnaire (FIQ), to 250 Spanish patients with fibromyalgia. RESULTS: PSPS-Spanish was found to have high internal consistency (Cronbach's α = 0.90 and the item-total r correlation coefficients ranged between 0.68 and 0.86). Principal components analysis revealed a one-factor structure which explained 61.4% of the variance. The test-retest correlation assessed with the intraclass correlation coefficient, over a 1-2 weeks interval, was 0.78. The total PSPS score was significantly correlated with all the questionnaires assessed (HADS, PVAS, PCS, and FIQ). CONCLUSIONS: The Spanish version of the PSPS appears to be a valid tool in assessing mental defeat in patients with fibromyalgia. In patients with fibromyalgia and Post-Traumatic Stress Disorder (PTSD), PSPS-Spanish correlates more intensely with FIQ than in patients without PTSD. Mental defeat seems to be a psychological construct different to pain catastrophizing.

[Imagined exposure as treatment of catastrophizing in fibromyalgia: a pilot study]. / Exposición en imaginación como tratamiento del catastrofismo en fibromialgia: un estudio piloto.

INTRODUCTION: We want to assess the effectiveness of a new approach (imagined exposure) for the Cognitive Behavioural Treatment (CBT) in fibromyalgia. STUDY DESIGN: Quasi-experimental design of a temporary nature in a single group with pre and post and with/without treatment. SUBJECTS AND METHODS: Fibromyalgia (FM) patients, who met the American College of Rheumatology's criteria for FM. In this study eight people took part, seven females and one male, selected from FM Cantabria Association. The CBT consisted of 11 group sessions and lasted 15 weeks. All patients were evaluated before and after the program. The data were based on the following scales: visual-analog scale (VAS) for pain intensity, the Fibromyalgia Impact Questionnaire (FIQ), the Pain Catastrophizing Scale (PCS) and the Hospital Anxiety and Depression Scale (HADS). RESULTS: Despite finding improvements in every variable, no significant differences were found between pre and postreatment in VAS, HADS and FIQ. However, after treatment, significant differences were found in PCS (p 0.05), and its three subscales. Moreover, rate decrease in rumination was higher after imagined exposure. CONCLUSION: These results suggest that CBT is effective either in catastrophizing decreasing or in rumination. Imagined exposure may enhance the results in particular cases. Further studies with larger samples are needed to confirm these results.

Exposición en imaginación como tratamiento del catastrofismo en fibromialgia: un estudio piloto / Imagined exposure as treatment of catastrophizing in fibromyalgia. A pilot study

Introducción. Se quiere determinar la eficacia de un nuevo componente (exposición en imaginación) dentro de un tratamiento cognitivo-conductual (TCC) en el dolor crónico. Diseño. Diseño cuasi-experimental, de serie temporal, de un solo grupo. Con medida pretratamiento y postratamiento con y sin tratamiento. Pacientes y método. Un grupo de pacientes (n=8) (siete mujeres y un hombre) con fibromialgia diagnosticados según los criterios del American College of Rheumatology (ACR). El TCC consistió en 11 sesiones de grupo y tuvo una duración de 15 semanas. Los pacientes fueron valorados al inicio y al final del programa. Se estudiaron las siguientes variables: la escala analógica visual (EAV), el nivel de catastrofismo y rumiación (PCS), el Cuestionario de Impacto de Fibromialgia (FIQ) y la sintomatología ansioso depresiva (HADS).Resultados. Aunque se encontraron mejoras en todas las variables, no se evidenciaron diferencias estadísticamente significativas en la EAV, el FIQ ni en la HADS. Sí se evidenciaron diferencias estadísticamente significativas en el PCS (p<0,05) y en sus tres subescalas. Además, el descenso en la puntuación de la rumiación con la exposición en imaginación fue superior. Conclusiones. El TCC es un tratamiento eficaz tanto para el descenso del catastrofismo como de la rumiación. La técnica de exposición en imaginación pudiera potenciar en determinados casos esos resultados. Se necesitan estudios con muestras más amplias para corroborar estos resultados (AU)

Introduction. We want to assess the effectiveness of a new approach (imagined exposure) for the Cognitive Behavioural Treatment (CBT) in fibromyalgia. Study design. Quasi-experimental design of a temporary nature in a single group with pre and post and with/without treatment. Subjects and methods. Fibromyalgia patients, who met the American College of Rheumatology’s criteria for FM. In this study eight people took part, seven females and one male, selected from fibromyalgia Cantabria Association. The CBT consisted of 11 group sessions and lasted15 weeks. All patients were evaluated before and after the program. The data were based on the following scales: visual-analog scale (VAS) for pain intensity, the Fibromyalgia Impact Questionnaire (FIQ), the Pain Catastrophizing Scale (PCS) and the Hospital Anxiety and Depression Scale (HADS).Results. Despite finding improvements in every variable, no significant differences were found betweenpre and postreatment in VAS, HADS and FIQ. However, after treatment, significant differences were found in PCS (p<0.05), and its three subscales. Moreover, rate decrease in rumination was higher after imagined exposure. Conclusion. These results suggest that CBT is effective either in catastrophizing decreasing or in rumination. Imagined exposure may enhance the results in particular cases. Further studies with larger samples are needed to confirm these results (AU)