Therapy of non-small-cell lung cancer (NSCLC) in patients with HIV infection

Incidence and mortality of AIDS patients have significantly declined in the developed countries due to the very active anti-HIV combination therapy av ailable today. Because of the prolongation of the survival expectancy of th ese patients, other non-AIDS defining tumours have been recently reported i n several cohort studies with increased frequency. We want to report the clinico-pathological features and the outcome of 39 p atients with lung cancer and HIV infection, collected by the Italian Cooper ative Group on AIDS and Tumors (GICAT) between 1986 and December 1997. As a control group, we decided to evaluate patients, less than 60 years of age, with lung cancer but without HIV infection seen at the CRO, Aviano, during 1995 and 1996. The median age of the study group patients was 38 years (range 28-58) and 9 0% of them were males. Sixty-nine percent of patients were intravenous drug users and HIV infection was asyntomatic in 41% of patients. NSCLC was obse rved in 78% of patients, SCLC in 13% and mesothelioma in 8%. Among NSCLC, a denocarcinoma was the most frequently observed histological subtype (48%). No differences were found as regards the stage of disease at diagnosis and the histologic subtype in comparison with the control group. The median ove rall survival was significantly shorter for patients with HIV infection whe n compared to that of the control group (5 months vs. 10 months, P < 0.0001 ). In conclusion, the outcome of patients with SNCLC and HIV infection seems w orse than that of the general population, suggesting a synergistic and/or a ddictive adverse effect of HIV on the outcome of lung cancer.