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Baluku JB, Namiiro S, Namanda B, Nabwana M, Andia-Biraro I, Worodria W, Salata R, Mfinanga S, Gerson S, Kirenga B. Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios in Distinguishing Lung Cancer in People with HIV. DISEASE MARKERS 2024; 2024:8822024. [PMID: 38292339 PMCID: PMC10827363 DOI: 10.1155/2024/8822024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
Objective The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) demonstrate good diagnostic accuracy in distinguishing lung cancer patients from healthy individuals, primarily in HIV-negative populations. We determined the sensitivity (Se), specificity (Sp), and area under the curve (AUC) of the NLR and PLR in discriminating between people living with HIV (PLWH) with and without lung cancer. Methods This is a comparative analysis of secondary data. Cases were PLWH with lung cancer from a retrospective cohort treated at the Uganda Cancer Institute. Controls were unmatched PLWH without lung cancer who were randomly selected from three HIV clinics in Uganda. Se, Sp, and AUC analysis and determination of optimal cutoffs were performed using receiver operating characteristic (ROC) curves. Results Of 115 PLWH (18 cases and 97 controls), 83 (72.2%) were female, 110 (95.7) were on ART, and the median (IQR) age was 46 (38-51) years. The median (IQR) NLR was higher among cases than controls (3.53 (3.14-7.71) vs. 0.92 (0.67-1.09), p < 0.001). Similarly, the PLR was higher among cases than controls (237.5 (177.8-361.6) vs. 123.6 (100.6-155.4), p=0.001). At a cutoff of 2.44, the respective Se, Sp, and AUC of the NLR were 87.5% (95% CI: 61.7%-98.4%), 100% (95% CI: 96.2%-100%), and 0.94 (95% CI: 0.85-1.00, p < 0.001). Similarly, the respective Se, Sp, and AUC for the PLR were 75% (95% CI: 47.6%-92.7%), 87.2% (95% CI: 78.8%-93.2%), and 0.81 (95% CI: 0.70-0.93, p < 0.001) at a cutoff of 196.3. Conclusion The NLR and PLR discriminated PLWH with and without lung cancer and could be useful in PLWH with respiratory symptoms in whom lung cancer can easily be misdiagnosed as other lung pathology.
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Affiliation(s)
- Joseph Baruch Baluku
- Makerere University Lung Institute, Kampala, Uganda
- Division of Pulmonology, Kiruddu National Referral Hospital, Kampala, Uganda
| | - Sharon Namiiro
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Brenda Namanda
- Division of Pulmonology, Kiruddu National Referral Hospital, Kampala, Uganda
| | - Martin Nabwana
- Makerere University–Johns Hopkins University Research Collaboration, Kampala, Uganda
| | - Irene Andia-Biraro
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - William Worodria
- Makerere University Lung Institute, Kampala, Uganda
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Robert Salata
- Department of Medicine, UH Cleveland Medical Center, Cleveland, USA
| | - Sayoki Mfinanga
- Muhimbili Center, National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Stanton Gerson
- School of Medicine, Case Western Reserve University, Cleveland, USA
| | - Bruce Kirenga
- Makerere University Lung Institute, Kampala, Uganda
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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2
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Basté Rotllan N. Potential use of multikinase inhibitors in immunosuppressed patients with malignancies including thyroid cancer. Cancer Med 2022; 11 Suppl 1:10-16. [PMID: 36202608 PMCID: PMC9537054 DOI: 10.1002/cam4.5106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 07/15/2022] [Accepted: 07/24/2022] [Indexed: 11/10/2022] Open
Abstract
In this article, we focus on a variety of immunosuppression scenarios and whether multikinase inhibitors, as systemic therapy for advanced thyroid carcinoma (TC), could be useful for the treatment of immunocompromised patients with TC. Lenvatinib and sorafenib, among other MKIs, have become the standard of care for advanced TC based on their efficacy data and despite their adverse effects. Currently, published data on MKIs in immunosuppressed patients are scarce. Secondary malignancies can arise in immunosuppressed patients who have undergone solid organ transplantation, human immunodeficiency virus-infected patients, and hematopoietic stem cell transplant recipients. This review will explore different immunosuppression settings, the risk of secondary malignancies in immunosuppressed patients, and the special characteristics of this population. Some considerations regarding anticancer treatment in immunosuppressed patients with advanced malignancies are reviewed.
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Affiliation(s)
- Neus Basté Rotllan
- Medical Oncology Department, Hospital Clinic Barcelona, Translational Genomics and Targeted Therapies in Solid TumorsAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS)BarcelonaSpain
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3
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Baluku JB, Bogere N, Namiiro S, Walusansa V, Andia-Biraro I, Worodria W, Kirenga B. HIV-related lung cancer in Uganda: a cohort study. Infect Agent Cancer 2022; 17:24. [PMID: 35668439 PMCID: PMC9169266 DOI: 10.1186/s13027-022-00439-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/24/2022] [Indexed: 11/15/2022] Open
Abstract
Background There are few reports on lung cancer among people with HIV (PWH) in Sub-Saharan Africa. In this report, we describe a cohort of PWH and lung cancer at the Uganda Cancer Institute.
Methods This retrospective cohort of PWH and lung cancer was managed at the Uganda Cancer Institute between 2008 and 2018. Sociodemographic and clinical data were abstracted from the patient charts. The median survival from diagnosis to death, loss-to-follow up or 31st December 2018, was estimated.
Results There were 18 people with HIV and lung cancer. The median (interquartile range, IQR) age was 49.5 (38.8–56.0) years, 11 (61.1%) were women and 5 (27.8%) were smokers. Of the 18 PWH, 13 (72.2%) were on antiretroviral therapy and the median (IQR) CD4 count (n = 13) was 380 (243.5–595) cells per mm3. Difficulty in breathing (88.9%), chest pain (78.6%, n = 11), cough (76.5%, n = 17) and weight loss (72.2%) were the commonest symptoms while pleural effusions were observed in 12 (66.7%). In this cohort, 8 (44.4%) were presumptively treated for tuberculosis before the diagnosis of lung cancer. Seven (38.9%) had an Eastern Cooperative Oncology Group performance status of 3. Non-small cell lung cancer was the predominant histological type observed in 17 (94.4%) of whom 14 (82.4%) had adenocarcinoma. Majority of PWH had stage IV disease (88.9%). The median (IQR) survival was 3.3 (1.1–13.2) months and all were either dead (72.2%) or lost-to-follow up (27.8%) at five years from diagnosis. Conclusion People with HIV and lung cancer in Uganda report low rates of smoking, present with advanced disease and post very poor survival rates. There is need for biomarkers for early detection of lung cancer in HIV.
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Affiliation(s)
- Joseph Baruch Baluku
- Makerere University Lung Institute, PO Box 26343, Kampala, Uganda. .,Kiruddu National Referral Hospital, Kampala, Uganda.
| | | | - Sharon Namiiro
- Makerere University Lung Institute, PO Box 26343, Kampala, Uganda
| | | | | | - William Worodria
- Makerere University College of Health Sciences, Kampala, Uganda.,Mulago National Referral Hospital, Kampala, Uganda
| | - Bruce Kirenga
- Makerere University Lung Institute, PO Box 26343, Kampala, Uganda.,Makerere University College of Health Sciences, Kampala, Uganda
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4
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Lavole A, Greillier L, Mazières J, Monnet I, Kiakouama-Maleka L, Quantin X, Spano JP, Lena H, Fraisse P, Janicot H, Audigier-Valette C, Langlais A, Morin F, Makinson A, Cadranel J. First-line carboplatin plus pemetrexed with pemetrexed maintenance in HIV-positive patients with advanced non-squamous non-small cell lung cancer: the phase II IFCT-1001 CHIVA trial. Eur Respir J 2020; 56:13993003.02066-2019. [PMID: 32444410 DOI: 10.1183/13993003.02066-2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/15/2020] [Indexed: 01/09/2023]
Abstract
HIV infection is an exclusion criterion in lung cancer trials. This multicentre phase II trial aimed to assess feasibility, efficacy and safety of first-line carboplatin plus pemetrexed (CaP) followed by pemetrexed (P) maintenance in people living with HIV (PLHIV) with advanced non-squamous non-small cell lung cancer (NS-NSCLC).Four cycles of CaP were followed by P-maintenance therapy in patients with Eastern Cooperative Oncology Group performance status ≤2. The primary objective was a disease control rate (DCR) ≥30% after 12 weeks.Of the 61 PLHIV enrolled, 49 (80%) had a performance status of 0-1, and 19 (31%) had brain metastases. Median CD4 lymphocyte count was 418 cells·µL-1 (range 18-1230), median CD4 lymphocyte nadir was 169.5 cells·µL-1 (1-822); 48 (80%) patients were virologically controlled. Four-cycle inductions were achieved by 38 (62%) patients, and 31 (51%) started P-maintenance (median of 4.1 cycles (range 1-19)). The 12-week DCR was 50.8% (95% CI 38.3-63.4) and partial response rate 21.3%. Median progression-free survival and overall survival were 3.5 (95% CI 2.7-4.4) and 7.6 months (5.7-12.8), respectively. Patients with a performance status of 0-1 had the longest median progression-free survival (4.3 months, 95% CI 3.1-5.2) and overall survival (11.9 months, 95% CI 6.4-14.3). During induction, CaP doublet was well tolerated apart from grade 3-4 haematological toxicities (neutropenia 53.8%; thrombocytopenia 35.0%; anaemia 30.0%). Two fatal treatment-related sepses were reported. No opportunistic infections were experienced.In PLHIV with advanced NS-NSCLC, first-line four-cycle CaP induction followed by P-maintenance was effective and reasonably well-tolerated. Further studies should evaluate combination strategies of CaP with immunotherapy in PLHIV.
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Affiliation(s)
- Armelle Lavole
- Service de Pneumologie, Assistance Publique - Hôpitaux de Paris (Hôpital Tenon) and Sorbonne Université, Paris, France
| | - Laurent Greillier
- Service d'Oncologie Multidisciplinaire & Innovations Thérapeutiques, Aix-Marseille Université, Assistance Publique - Hôpitaux de Marseille (Hôpital Nord), Marseille, France
| | | | | | | | | | - Jean Philippe Spano
- Service d'Oncologie Médicale, Assistance Publique - Hôpitaux de Paris (Hôpital de la Pitié-Salpêtrière), Paris, France
| | - Herve Lena
- Service de Pneumologie, CHU, Rennes, France
| | - Philippe Fraisse
- Service de Pneumologie, Nouvel Hôpital Civil, Strasbourg, France
| | - Henri Janicot
- Service de Pneumologie, CHU, Clermont-Ferrand, France
| | | | | | - Franck Morin
- French Cooperative Thoracic Intergroup (IFCT), Paris, France
| | - Alain Makinson
- Service des maladies infectieuses et tropicales, CHU Montpellier and InsermU1175, Université de Montpellier, Montpellier, France
| | - Jacques Cadranel
- Service de Pneumologie, Assistance Publique - Hôpitaux de Paris (Hôpital Tenon) and Sorbonne Université, Paris, France
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5
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Treating cancer with immunotherapy in HIV-positive patients: A challenging reality. Crit Rev Oncol Hematol 2019; 145:102836. [PMID: 31918216 DOI: 10.1016/j.critrevonc.2019.102836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/24/2019] [Accepted: 11/14/2019] [Indexed: 01/08/2023] Open
Abstract
Immunotherapy has widely changed the management of different malignancies. However, efficacy and safety of immune checkpoint inhibitors (ICIs) are not well established in people living with HIV (PLWH). Population of HIV-positive patients has deeply changed after the introduction of modern antiretroviral therapy (ART) and available data of immunotherapy in this subgroup are inadequate considering that cancer has become a leading cause of death and morbidity in this population. Moreover, there are many similarities between cancer and infectious antigen stimulation so that ICIs are even under evaluation as specific HIV treatment. Most of literature on this topic is based on small case series that suggest that immunotherapy for PLWH seems to be as effective as in HIV-negative population with a good safety profile. In this article we review literature on HIV and immunotherapy and we collect many case series available in different malignancies, with a brief focus on lung cancer.
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6
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Salhab HA, Fares MY, Khachfe HH, Khachfe HM. Epidemiological Study of Lung Cancer Incidence in Lebanon. ACTA ACUST UNITED AC 2019; 55:medicina55060217. [PMID: 31141934 PMCID: PMC6631477 DOI: 10.3390/medicina55060217] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/10/2019] [Accepted: 05/22/2019] [Indexed: 01/06/2023]
Abstract
Background and Objectives: Lung cancer (LC) is the most common cancer in the world. Developing countries in the Middle East and North Africa (MENA) region, including Lebanon, have witnessed a great increase in the incidence rates of this disease. The aim of our study is to investigate the incidence rates of lung cancer in Lebanon from 2005 to 2015 and to compare these rates to other countries from the MENA region and other regions of the world. Material and Methods: Lung cancer data for the years 2005-2015 were collected from the National Cancer Registry of Lebanon and stratified by gender and age group. Age-specific and age-standardized incidence rates were calculated and analyzed using joinpoint regression. Age-standardized incidence rates to the world population (ASR(w)) for other countries were obtained from two online databases. Results: Lung cancer ranked as the second most common cancer in Lebanon and accounted for 9.2% of all newly diagnosed cancers. Lung cancer ASR(w) showed a significantly increasing trend over the period studied for males and females. Lung cancer ASR(w) among males in Lebanon came second after Malta when compared to other MENA countries, but it was among the lowest when compared to non-MENA countries. For females, Lebanon ranked first when compared to other MENA countries but was among the lowest when compared to countries in other regions of the world. The lung cancer incidence rate increased with age in both sexes and 89.2% of patients were 50 years of age or older. Conclusion: Lebanon has the highest incidence of LC in females and the second highest for males in the MENA region. The lung cancer incidence rate is on the rise and older age groups are much more burdened by this disease than the young ones. Several risk factors, particularly smoking, play a role in increased LC incidence among the Lebanese population.
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Affiliation(s)
- Hamza A Salhab
- Faculty of Medicine, American University of Beirut, Beirut 1107, Lebanon.
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut 6573, Lebanon.
| | - Mohamad Y Fares
- Faculty of Medicine, American University of Beirut, Beirut 1107, Lebanon.
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut 6573, Lebanon.
| | - Hussein H Khachfe
- Faculty of Medicine, American University of Beirut, Beirut 1107, Lebanon.
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut 6573, Lebanon.
| | - Hassan M Khachfe
- School of Arts and Sciences, and the Lebanese Institute for Biomedical Research and Application (LIBRA), Lebanese International University (LIU), Beirut 1105, Lebanon.
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7
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Houshmand F, Aly FZ, Bowling MR. A novel diagnostic approach for Pneumocystis jirovecii pneumonia using fine-needle aspiration, electromagnetic navigational bronchoscopy and rapid on-site evaluation. Ann Thorac Med 2019; 14:285-287. [PMID: 31620213 PMCID: PMC6784444 DOI: 10.4103/atm.atm_171_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cavitary lung lesions are common in patients with human immunodeficiency virus infections. Both atypical infections and thoracic malignancies can manifest as a cavitary pulmonary lesion. Standard bronchoscopy is commonly used to evaluate these abnormalities but is limited in its ability to fully assess for cancer and infection. Bronchoalveolar lavage samples are likely to aid in the diagnosis of infection but are less useful in the evaluation of malignancy. In addition, many of these pulmonary lesions are located in the periphery of the lung and are not accessible for tissue sampling by standard bronchoscopy. We present a unique presentation of Pneumocystis jirovecii pneumonia and discuss the utility of electromagnetic navigational bronchoscopy in the evaluation of immunocompromised patients with peripheral cavitary lung lesion.
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Affiliation(s)
- Farnaz Houshmand
- Berkeley Medical Center, West Virginia University, Martinsburg, WV, USA
| | - Fatima Zahra Aly
- Department of Pulmonary and Critical Care Medicine, University of Florida, Gainesville, FL, USA
| | - Mark Rollin Bowling
- Division of Pulmonary, Critical Care, and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA
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8
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Zheng J, Wang L, Cheng Z, Pei Z, Zhang Z, Li Z, Zhang X, Yan D, Xia Q, Feng Y, Song Y, Chen W, Zhang X, Xu J, Wang J. Molecular Changes of Lung Malignancy in HIV Infection. Sci Rep 2018; 8:13128. [PMID: 30177858 PMCID: PMC6120915 DOI: 10.1038/s41598-018-31572-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 08/07/2018] [Indexed: 01/02/2023] Open
Abstract
Malignancy of the lung is a major source of morbidity and mortality in persons with human immunodeficiency virus infection; as the most prevalent non-acquired immunodeficiency syndrome-defining malignancy, it represents an important and growing problem confronting HIV-infected patients. To evaluate the molecular changes of lung malignancy in HIV infection, we analyzed differential gene expression profiles and screened for early detection biomarkers of HIV-associated lung cancer using Affymetrix arrays and IPA analysis. A total of 59 patients were diagnosed with HIV-associated lung cancer from Jan 2010 to May 2018. The primary outcome was a significant difference in survival outcome between stages III-IV (10.46 ± 1.87 months) and I-II (17.66 ± 2.88 months). We identified 758 differentially expressed genes in HIV-associated lung cancer. The expression levels of SIX1 and TFAP2A are specifically increased in HIV-associated lung cancer and are associated with poorly differentiated tumor tissue. We also found decreased ADH1B, INMT and SYNPO2 mRNA levels in HIV lung cancer. A comprehensive network and pathway analysis of the dysregulated genes revealed that these genes were associated with four network functions and six canonical pathways relevant to the development of HIV-associated lung cancer. The molecular changes in lung malignancy may help screen the growing population of HIV patients who have or will develop this malignancy.
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Affiliation(s)
- Jianghua Zheng
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China.,Department of Laboratory Medicine, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China
| | - Lin Wang
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China
| | - Zenghui Cheng
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China.,Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Zenglin Pei
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China
| | - Zhiyong Zhang
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China
| | - Zehuan Li
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China.,Department of General Surgery, Zhongshan Hospital, Fudan University, 200032, Shanghai, P. R. China
| | - Xuan Zhang
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China
| | - Dong Yan
- Department of Medical Oncology, Beijing Chaoyang Hospital affiliated to Capital Medical University, Beijing, China
| | - Qianlin Xia
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China
| | - Yanling Feng
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China
| | - Yanzheng Song
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China
| | - Weiping Chen
- Microarray Core, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Xiaoyan Zhang
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China
| | - Jianqing Xu
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China
| | - Jin Wang
- Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, P.R. China.
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Nonsmall cell lung cancer from HIV-infected patients expressed programmed cell death-ligand 1 with marked inflammatory infiltrates. AIDS 2018; 32:461-468. [PMID: 29194117 DOI: 10.1097/qad.0000000000001713] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Immunotherapies targeting the programmed cell death-1 (PD-1)/PD-ligand 1 (PD-L1) checkpoint improved prognosis in lung cancer. PD-1/PD-L1 status, however, has not been investigated in human immunodeficiency virus (HIV)-positive patients. This study assessed PD-L1 status and tumor immune-cell infiltration in nonsmall cell lung cancer (NSCLC) in HIV patients. METHODS Consecutive HIV patients treated between 1996 and 2014 were enrolled. PD-L1 tumor expression was assessed using immunohistochemistry with two antibodies (clones 5H1 and E1L3N), and tumor immune-cell infiltration with CD3, CD4, CD8, CD20, CD163, and MPO. PD-L1 expression and immune infiltration results were compared with those of 54 NSCLCs from unknown HIV status patients. RESULTS Thirty-four HIV-positive patients were evaluated: predominantly men (88.2%) (median age: 51.1 years) presenting stage IV (38.2%) adenocarcinomas (76.5%). The median blood CD4 count was 480 cells/μL (86-1120) and 64% exhibited undetectable viral load. The PD-L1 score (percentage of positive cells × intensity) was higher in HIV-positive than HIV-undetermined patients with the E1L3N clone [median (range) 0 (0-150) versus 0 (0-26.7), P = 0.047], yet not with the 5H1 clone [0 (0-120) versus 0 (0-26.7) P = 0.07, respectively]. PD-L1 expression frequency did not differ between both cohorts (18.7 versus 9.3% using E1L3N and 10 versus 5.6% using 5H1 clone, respectively). There were significantly greater cytotoxic T-cell (P < 0.001), B-lymphocyte (P = 0.005), and activated macrophage (P < 0.001) infiltrations in the HIV-positive patients, but no differences for CD4 T cells. CONCLUSION Tumors in HIV-positive patients seem to express higher PD-L1 levels with increased immune infiltration, supporting their inclusion in clinical trials assessing immune checkpoint inhibitors.
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10
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Domblides C, Canellas A, Wislez M, Fallet V, Antoine M, Crequit P, Cadranel J, Lavolé A. [Lung cancer in HIV-infected patients]. Bull Cancer 2017; 105:111-119. [PMID: 29269175 DOI: 10.1016/j.bulcan.2017.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 11/13/2017] [Indexed: 12/20/2022]
Abstract
Until 1996, AIDS was the leading cause of deaths from HIV infection. In 2010, because of introduction of powerful antiretroviral therapies, AIDS represented less than 25% of deaths. Cancer has become the leading cause of death in this population, and, because of smoking and immunosuppression, lung cancer risk is more important than in general population. Furthermore, treatment is more difficult, due to potential interactions between antiretroviral and anticancer therapies, to comorbidities and to tumor aggressiveness. Research will focus on molecular biology, immunotherapies and lung cancer screening in order to improve survival of HIV patients with lung cancer. For all these reasons, HIV patients must be included in clinical trials.
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Affiliation(s)
- Charlotte Domblides
- Assistance publique-Hôpitaux de Paris, hôpital Tenon, service de pneumologie, 4, rue de la Chine, 75020 Paris, France
| | - Anthony Canellas
- Assistance publique-Hôpitaux de Paris, hôpital Tenon, service de pneumologie, 4, rue de la Chine, 75020 Paris, France
| | - Marie Wislez
- Assistance publique-Hôpitaux de Paris, hôpital Tenon, service de pneumologie, 4, rue de la Chine, 75020 Paris, France; Université Paris-VI, université Pierre-et-Marie-Curie, GRC-UPMC 04 Théranoscan, 4, place Jussieu, 75252 Paris cedex 05, France
| | - Vincent Fallet
- Assistance publique-Hôpitaux de Paris, hôpital Tenon, service de pneumologie, 4, rue de la Chine, 75020 Paris, France
| | - Martine Antoine
- Assistance publique-Hôpitaux de Paris, hôpital Tenon, service d'anatomopathologie, 4, rue de la Chine, 75020 Paris, France
| | - Perrine Crequit
- Assistance publique-Hôpitaux de Paris, hôpital Tenon, service de pneumologie, 4, rue de la Chine, 75020 Paris, France; Université Paris-VI, université Pierre-et-Marie-Curie, GRC-UPMC 04 Théranoscan, 4, place Jussieu, 75252 Paris cedex 05, France
| | - Jacques Cadranel
- Assistance publique-Hôpitaux de Paris, hôpital Tenon, service de pneumologie, 4, rue de la Chine, 75020 Paris, France; Université Paris-VI, université Pierre-et-Marie-Curie, GRC-UPMC 04 Théranoscan, 4, place Jussieu, 75252 Paris cedex 05, France
| | - Armelle Lavolé
- Assistance publique-Hôpitaux de Paris, hôpital Tenon, service de pneumologie, 4, rue de la Chine, 75020 Paris, France; Université Paris-VI, université Pierre-et-Marie-Curie, GRC-UPMC 04 Théranoscan, 4, place Jussieu, 75252 Paris cedex 05, France.
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11
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Rodríguez Arrondo F, von Wichmann MÁ, Camino X, Goenaga MÁ, Ibarguren M, Azcune H, Bustinduy MJ, Ferrero O, Muñoz J, Ibarra S, Aguirrebengoa K, Goicoetxea J, Bereciartua E, Montejo M, García MA, Martínez E, Portu J, Metola L, Silvariño R, Sarasqueta C, Arrizabalaga J, Iribarren JA. A case-control study of non-AIDS-defining cancers in a prospective cohort of HIV-infected patients. Med Clin (Barc) 2017; 150:291-296. [PMID: 28528797 DOI: 10.1016/j.medcli.2017.03.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 12/31/2022]
Abstract
INTRODUCTION We present a case-control study of non-AIDS-defining cancers (NADCs) in a cohort of HIV-infected patients where we value the incidence, survival and prognostic factors of mortality. METHODS All NADCs diagnosis conducted from 2007 to 2011 in 7 hospitals were collected prospectively, with a subsequent follow up until December 2013. A control group of 221 HIV patients without a diagnosis of cancer was randomly selected. RESULTS Two hundred and twenty-one NADCs were diagnosed in an initial cohort of 7,067 HIV-infected patients. The most common were: hepatocellular carcinoma 20.5%, lung 18.7%, head and neck 11.9% and anal 10.5%. The incidence rate of NADCs development was 7.84/1,000 people-year. In addition to aging and smoking, time on ART (OR 1.11; 95% CI 1.05-1.17) and PI use (OR 1.72; 95% CI 1.0-2.96) increased the risk of developing a NADC. During follow-up 53.42% died, with a median survival time of 199.5 days. In the analysis of the prognostic factors of mortality the low values of CD4 at tumour diagnosis (OR 0.99; 95% CI 0.99-1.0; P=.033), and the previous diagnosis of AIDS (OR 2.06; 95% CI 1.08-3.92) were associated with higher mortality. CONCLUSIONS Predictors of NADCs in our cohort were age, smoking, CD4 lymphocytes and time on ART. Mortality is high, with NADC risk factors being low CD4 count and previous diagnosis of AIDS.
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Affiliation(s)
| | - Miguel Ángel von Wichmann
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Xabier Camino
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Miguel Ángel Goenaga
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Maialen Ibarguren
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Harkaitz Azcune
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - María Jesús Bustinduy
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
| | - Oscar Ferrero
- Servicio de Enfermedades Infecciosas, Hospital Basurto, Bilbao, Vizcaya, España
| | - Josefa Muñoz
- Servicio de Enfermedades Infecciosas, Hospital Basurto, Bilbao, Vizcaya, España
| | - Sofía Ibarra
- Servicio de Enfermedades Infecciosas, Hospital Basurto, Bilbao, Vizcaya, España
| | - Koldo Aguirrebengoa
- Servicio de Enfermedades Infecciosas, Hospital de Cruces, Bilbao, Vizcaya, España
| | - Josune Goicoetxea
- Servicio de Enfermedades Infecciosas, Hospital de Cruces, Bilbao, Vizcaya, España
| | - Elena Bereciartua
- Servicio de Enfermedades Infecciosas, Hospital de Cruces, Bilbao, Vizcaya, España
| | - Miguel Montejo
- Servicio de Enfermedades Infecciosas, Hospital de Cruces, Bilbao, Vizcaya, España
| | - M Asunción García
- Servicio de Enfermedades Infecciosas, Hospital Galdakao, Galdakao, Vizcaya, España
| | - Eduardo Martínez
- Servicio de Enfermedades Infecciosas, Hospital Galdakao, Galdakao, Vizcaya, España
| | - Joseba Portu
- Servicio de Médicina Interna, Hospital Txagorritxu, Vitoria-Gasteiz, Álava, España
| | - Luis Metola
- Servicio de Enfermedades Infecciosas, Hospital San Pedro, Logroño, La Rioja, España
| | - Rafael Silvariño
- Servicio de Médicina Interna, Hospital San Eloy, Baracaldo, Vizcaya, España
| | - Cristina Sarasqueta
- Servicio de Enfermedades Infecciosas, Instituto BioDonostia, San Sebastián, Guipúzcoa, España
| | - Julio Arrizabalaga
- Servicio de Enfermedades Infecciosas, Instituto BioDonostia, San Sebastián, Guipúzcoa, España
| | - Jose Antonio Iribarren
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España
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Takahashi S, Okuma Y, Watanabe K, Hosomi Y, Imamura A, Okamura T, Gemma A. Single-institutional experience of clinicopathological analysis and treatment for lung cancer patients with human immunodeficiency virus infection. Mol Clin Oncol 2017; 6:765-769. [PMID: 28515928 PMCID: PMC5431141 DOI: 10.3892/mco.2017.1214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 02/13/2017] [Indexed: 11/05/2022] Open
Abstract
The advent of antiretroviral therapy has changed the disease spectrum constitution among patients living with human immunodeficiency virus (HIV), while the incidence of death due to non-AIDS-defining cancers, particularly lung cancer, continues to increase in the USA and Europe. However, the availability of detailed reports of the clinical characteristics of lung cancer among Asian populations is limited. The present study retrospectively analyzed the clinical characteristics, treatment regimens and outcomes of lung cancer patients with HIV who were treated in a single institution between 1988 and 2013. Of the 20 lung cancer patients living with HIV included in this study, 90% were diagnosed since 1996 in the post-antiretroviral era. The median CD4+ cell count was 373.5/µl, whereas 65% of the patients were diagnosed with adenocarcinoma and 30% with squamous cell carcinoma. Epidermal growth factor receptor mutations were detected in 3 (27%) of the 11 specimens for which data were available, of which 65% had advanced-stage disease. Of the 20 patients, 9 underwent surgery, 6 received radiotherapy and 5 received chemotherapy as a first-line treatment. Treatment was generally well-tolerated. The median survival period was 35.8 months for all stages and 14.0 months for advanced stages. The treatment outcomes in our institution were favorable in comparison with previous studies from the USA and Europe, although these findings may be due to ethnic differences or the efficacy of treatment for HIV and lung cancer.
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Affiliation(s)
- Satoshi Takahashi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo 113-8602, Japan
| | - Yusuke Okuma
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan
- Division of Oncology, Research Center for Medical Sciences, Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Kageaki Watanabe
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan
| | - Akifumi Imamura
- Department of Infectious Diseases, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan
| | - Tatsuru Okamura
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo 113-8677, Japan
| | - Akihiko Gemma
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo 113-8602, Japan
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Cheng Z, Shan F, Liu J, Shi Y, Zhang Z, Wu G. Clinical and computed tomography findings in Chinese lung cancer patients with HIV infection: A multi-center study. Thorac Cancer 2017; 8:238-245. [PMID: 28294549 PMCID: PMC5415480 DOI: 10.1111/1759-7714.12429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/07/2017] [Accepted: 02/07/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The study was conducted to investigate clinical and computed tomography (CT) features in Chinese lung cancer patients with human immunodeficiency virus (HIV). METHODS Forty consecutive lung cancer patients with HIV were included. Clinical data were collected, and CT features were reviewed and measured. The factors associated with stages of cancer and the CT features with opportunistic pulmonary infections (OPIs) were also analyzed. RESULTS Thirty-four of the patients were men (85%), and the mean age was 57.5 years. The mean CD4 count was 288 cells/μL, and 23 patients received highly active antiretroviral therapy. OPIs were common (50%). The major histological type (85%) was non-small cell lung cancer (NSCLC), and 15 NSCLC patients (44%) were in stages IIIb and IV. NSCLC patients with an OPI were more common in the advanced stages compared with those without an OPI (P = 0.04). There were no significant differences in advanced and non-advanced stages in terms of CD4 level, highly active antiretroviral therapy, and smoking (P = 0.31, P = 1.00; P = 0.49, respectively). The average size of tumors was 4.5 cm. Irregularly shaped or larger sized tumors were associated with OPIs (P = 0.03, P = 0.04, respectively). CONCLUSIONS The persistence of locally irregular and large lesions in middle-aged men with HIV and a history of OPIs should be an alert for lung cancer, and clinical management is needed.
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Affiliation(s)
- Zenghui Cheng
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.,Department of Radiology, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai, China
| | - Fei Shan
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jinxin Liu
- Department of Radiology, Guangzhou Eighth People's Hospital, Guangzhou, China
| | - Yuxin Shi
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Zhiyong Zhang
- Department of Radiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.,Headmaster's Office, Fudan University, Shanghai, China.,Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guowei Wu
- Department of Radiology, Guangxi Longtan Hospital, Liuzhou, China
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Evaluation of a Flexible NOTA-RGD Kit Solution Using Gallium-68 from Different 68Ge/68Ga-Generators: Pharmacokinetics and Biodistribution in Nonhuman Primates and Demonstration of Solitary Pulmonary Nodule Imaging in Humans. Mol Imaging Biol 2016; 19:469-482. [DOI: 10.1007/s11307-016-1014-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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15
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Stanton CA, Papandonatos GD, Shuter J, Bicki A, Lloyd-Richardson EE, de Dios MA, Morrow KM, Makgoeng SB, Tashima KT, Niaura RS. Outcomes of a Tailored Intervention for Cigarette Smoking Cessation Among Latinos Living With HIV/AIDS. Nicotine Tob Res 2016; 17:975-82. [PMID: 26180222 DOI: 10.1093/ntr/ntv014] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Tobacco use has emerged as a leading killer among persons living with HIV, with effective approaches to tobacco treatment still unknown. HIV infection is nearly 3 times as prevalent in Latinos than in non-Latino Whites. This study reports the results of a randomized trial comparing a tailored intervention to brief counseling for smoking cessation among Latino smokers living with HIV (LSLWH). METHODS LSLWH (N = 302; 36% female, 10% employed full-time, 49% born in United States) were randomized to 4 in-person sessions of a tailored intervention (Aurora) or 2 in-person sessions of brief advice (enhanced standard care [ESC]). Both groups received 8 weeks of nicotine replacement therapy (NRT) patch. Biochemically validated 6- and 12-month 7-day point-prevalence abstinence (PPA) rates were compared, along with secondary outcomes (e.g., reduction to light smoking, NRT adherence). RESULTS Seven-day PPA rates reached 8% versus 11% at 6 months and 6% versus 7% at 12 months, for Aurora and ESC, respectively, with no between-group differences (p values > .40). Significant changes from baseline to 6 and 12 months among intervention targets were noted (percentage reduction in heavy smoking and dependence; increases in knowledge and self-efficacy). Baseline smoking frequency, older age, and higher intensity of patch use during the trial emerged as significant predictors of abstinence at 6 months. CONCLUSIONS There was no evidence that the tailored intervention improved cessation rates. Interventions that encourage use of, and adherence to, empirically validated cessation aids require further development to reduce tobacco-related death and disease in this vulnerable population.
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Affiliation(s)
- Cassandra A Stanton
- Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center; Schroeder Institute for Tobacco Research and Policy Studies, American Legacy Foundation; Westat, Behavioral Health Group; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University;
| | | | - Jonathan Shuter
- Montefiore Medical Center, Albert Einstein College of Medicine
| | - Alexandra Bicki
- Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center
| | - Elizabeth E Lloyd-Richardson
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University; Department of Psychology, University of Massachusetts
| | - Marcel A de Dios
- Department of Health Disparities Research, MD Anderson Cancer Center
| | - Kathleen M Morrow
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
| | - Solomon B Makgoeng
- Department of Oncology, Georgetown University Medical Center/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center
| | - Karen T Tashima
- Department of Medicine, The Miriam Hospital, The Warren Alpert Medical School of Brown University
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies, American Legacy Foundation
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Moltó J, Moran T, Sirera G, Clotet B. Lung cancer in HIV-infected patients in the combination antiretroviral treatment era. Transl Lung Cancer Res 2016; 4:678-88. [PMID: 26798577 DOI: 10.3978/j.issn.2218-6751.2015.08.10] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The advent of combination antiretroviral treatment (cART) has been followed by a decrease in HIV-associated morbidity and mortality, but also by an apparent increase in the incidence of non-AIDS-defining cancers (NADCs). The risk of lung cancer is substantially higher in HIV-infected patients than in the general population, in part due to aging and tobacco use, and it is the most frequent NADC. The management of lung cancer in HIV-infected patients has some peculiarities that need to be taken into account. This review focuses on the epidemiology, risk factors, and clinical management of lung cancer in HIV-infected patients. In addition, screening tools and future perspectives are also discussed.
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Affiliation(s)
- José Moltó
- 1 Fundació Lluita contra la Sida, Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 2 Universitat Autònoma de Barcelona (UAB), Barcelona, Spain ; 3 Medical Oncology Department, Catalan Institute of Oncology (ICO-Badalona), Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 4 Fundació IrsiCaixa, Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 5 Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Spain
| | - Teresa Moran
- 1 Fundació Lluita contra la Sida, Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 2 Universitat Autònoma de Barcelona (UAB), Barcelona, Spain ; 3 Medical Oncology Department, Catalan Institute of Oncology (ICO-Badalona), Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 4 Fundació IrsiCaixa, Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 5 Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Spain
| | - Guillem Sirera
- 1 Fundació Lluita contra la Sida, Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 2 Universitat Autònoma de Barcelona (UAB), Barcelona, Spain ; 3 Medical Oncology Department, Catalan Institute of Oncology (ICO-Badalona), Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 4 Fundació IrsiCaixa, Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 5 Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Spain
| | - Bonaventura Clotet
- 1 Fundació Lluita contra la Sida, Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 2 Universitat Autònoma de Barcelona (UAB), Barcelona, Spain ; 3 Medical Oncology Department, Catalan Institute of Oncology (ICO-Badalona), Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 4 Fundació IrsiCaixa, Hospital Universitari Germans Trias i Pujol, Badalona, Spain ; 5 Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Spain
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A multi-institutional study of clinicopathological features and molecular epidemiology of epidermal growth factor receptor mutations in lung cancer patients living with human immunodeficiency virus infection. J Cancer Res Clin Oncol 2015; 141:1669-78. [PMID: 25800620 DOI: 10.1007/s00432-015-1956-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 03/12/2015] [Indexed: 12/23/2022]
Abstract
PURPOSE Lung cancer has become a crucial problem among individuals living with the human immunodeficiency virus (HIV) and causes high mortality in Western countries. Japan has an increasing number of newly infected HIV patients, and lung cancer is becoming a theme in this population. However, clinical factors of this particular population in East Asian are unclear given the identification of ethnic differences in lung cancer in the general population. METHODS From 1986 to 2013, a retrospective nationwide study involving Japanese patients living with HIV and diagnosed with lung cancer was undertaken. RESULTS Forty-three lung cancer patients with HIV were identified (median age, 60.0 years; males, 97.7%; early-stage cancer, 37.2%; metastatic cancer, 34.9%), 41 (95.3%) of whom developed lung cancer in the antiretroviral era. The median CD4-positive T-cell count was 326 cells/µL. Adenocarcinoma was the most frequent histology (55.8%), followed by squamous cell carcinoma (27.9%). Epidermal growth factor receptor (EGFR) status was examined in 14 patients; five (35.7%) had EGFR mutations. The median overall survival time was 25.1 months for all stages and 7.9 months for advanced-stage cancer. Using univariate analysis, the only favorable prognostic factor for overall survival was cancer stage (p = 0.02). CONCLUSIONS The incidence of lung cancer among HIV patients in Japan has been increasing in the past decade. The present Japanese cohort showed similar EGFR mutation status similar to that of general population. The ethnic differences known in the general population were seen even in the population living with HIV, implying distinct clinical characteristics and outcomes from those reported in Western countries.
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18
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Okuma Y, Hosomi Y, Imamura A. Lung cancer patients harboring epidermal growth factor receptor mutation among those infected by human immunodeficiency virus. Onco Targets Ther 2014; 8:111-5. [PMID: 25678798 PMCID: PMC4317148 DOI: 10.2147/ott.s76712] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
With the advent of antiretroviral therapy, lung cancer has become a crucial health problem among individuals living with human immunodeficiency virus (HIV). In East Asian populations, the frequency of lung cancer patients harboring epidermal growth factor receptor (EGFR) mutations is greater than in other populations. Herein, we present two cases of advanced non-small cell lung cancer with EGFR mutations in patients treated with EGFR-tyrosine kinase inhibitors. Both patients were male, 67 and 59 years of age, with known HIV infection and immunologically stable disease with antiretroviral therapy. Case 1 was treated with erlotinib for recurrent adenocarcinoma metastasizing to the liver and brain harboring EGFR mutation in exon 21 L858R. The duration of treatment efficacy was 9.7 months. Case 2 had an EGFR mutation exon 19 in-frame deletion with bone metastasis and was treated with gefitinib for 22.1 months in combination with antiretroviral therapy. These advanced lung cancer patients living with HIV with EGFR mutations demonstrate the promising effectiveness and safety of EGFR-tyrosine kinase inhibitors concomitant with antiretroviral therapy for an extended period.
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Affiliation(s)
- Yusuke Okuma
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan
| | - Yukio Hosomi
- Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan
| | - Akifumi Imamura
- Department of Infectious Disease, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan
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Chen JC, Hwang JH. Sleep apnea increased incidence of primary central nervous system cancers: a nationwide cohort study. Sleep Med 2014; 15:749-54. [PMID: 24891080 DOI: 10.1016/j.sleep.2013.11.782] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 11/02/2013] [Accepted: 11/06/2013] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) was associated with increased incidence of all cancers. We aimed to determine the risk for primary central nervous system (CNS) cancers in patients with sleep apnea syndrome. METHODS A total of 23,055 incident cases of newly diagnosed sleep apnea syndrome (sleep apnea group) were identified between 2000 and 2003 in the medical claims database of Taiwan's National Health Institute (NHI) program and were matched by age and gender to patients without OSA (comparison group) in the same period. The occurrence of primary malignant CNS cancers was measured 2 years after the index date over a 10-year period. RESULTS The incidence density of primary CNS cancers (per 10,000 individual-years) was 2.14 and 1.28, respectively, for the OSA and comparison groups. The overall risk for developing primary CNS cancers was significantly higher in the OSA group (adjusted hazard ratio [HR], 1.54; P=0.046) after adjusting for age, gender, and obesity, among other variables. Subgroup analysis revealed a significantly higher risk for primary brain cancers but not primary spinal cord cancers in the OSA subgroup (adjusted HR, 1.71; P=0.027). The analysis also revealed a significantly higher risk for primary CNS cancers in the insomnia with OSA subgroup (adjusted HR, 2.20; P=0.001) and in the OSA without surgical treatment subgroup (adjusted HR, 1.831; P=0.003). CONCLUSIONS OSA, especially with insomnia, may increase the risk for primary CNS cancer development, though surgical treatment may reduce this risk in participants with OSA.
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Affiliation(s)
- Jin-Cherng Chen
- Department of Neurosurgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Juen-Haur Hwang
- School of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; Department of Sleep Center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
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Hu LY, Chen PM, Hu YW, Shen CC, Perng CL, Su TP, Yen SH, Tzeng CH, Chiou TJ, Yeh CM, Chen TJ, Wang WS, Liu CJ. The risk of cancer among patients with sleep disturbance: a nationwide retrospective study in Taiwan. Ann Epidemiol 2013; 23:757-61. [DOI: 10.1016/j.annepidem.2013.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Alberg AJ, Brock MV, Ford JG, Samet JM, Spivack SD. Epidemiology of lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143:e1S-e29S. [PMID: 23649439 DOI: 10.1378/chest.12-2345] [Citation(s) in RCA: 459] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Ever since a lung cancer epidemic emerged in the mid-1900 s, the epidemiology of lung cancer has been intensively investigated to characterize its causes and patterns of occurrence. This report summarizes the key findings of this research. METHODS A detailed literature search provided the basis for a narrative review, identifying and summarizing key reports on population patterns and factors that affect lung cancer risk. RESULTS Established environmental risk factors for lung cancer include smoking cigarettes and other tobacco products and exposure to secondhand tobacco smoke, occupational lung carcinogens, radiation, and indoor and outdoor air pollution. Cigarette smoking is the predominant cause of lung cancer and the leading worldwide cause of cancer death. Smoking prevalence in developing nations has increased, starting new lung cancer epidemics in these nations. A positive family history and acquired lung disease are examples of host factors that are clinically useful risk indicators. Risk prediction models based on lung cancer risk factors have been developed, but further refinement is needed to provide clinically useful risk stratification. Promising biomarkers of lung cancer risk and early detection have been identified, but none are ready for broad clinical application. CONCLUSIONS Almost all lung cancer deaths are caused by cigarette smoking, underscoring the need for ongoing efforts at tobacco control throughout the world. Further research is needed into the reasons underlying lung cancer disparities, the causes of lung cancer in never smokers, the potential role of HIV in lung carcinogenesis, and the development of biomarkers.
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Affiliation(s)
- Anthony J Alberg
- Hollings Cancer Center and the Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC.
| | - Malcolm V Brock
- Department of Surgery, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Jean G Ford
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jonathan M Samet
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Simon D Spivack
- Division of Pulmonary Medicine, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
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Chang DH, Rutledge JR, Patel AA, Heerdt BG, Augenlicht LH, Korst RJ. The effect of lung cancer on cytokine expression in peripheral blood mononuclear cells. PLoS One 2013; 8:e64456. [PMID: 23762239 PMCID: PMC3675097 DOI: 10.1371/journal.pone.0064456] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 04/15/2013] [Indexed: 01/04/2023] Open
Abstract
The purpose of this study is to evaluate cytokine expression by peripheral blood mononuclear cells (PBMC) from stage I lung cancer patients and to confirm these expression patterns by exposing PBMCs to lung cancer cells in vitro. Five altered cytokines in stage I lung cancer patients (CCL3, IL8, IL1β, CXCL10, sIL2Rα) were identified in plasma from subjects (n = 15) before and after resection using a 30-plex panel protein assay. Gene expression studies using quantitative RT-qPCR were performed on PBMCs from stage I lung cancer patients (n = 62) before and after resection, and compared to non-cancer patients (n = 32) before and after surgery for benign disease. Co-culture experiments that exposed healthy donor PBMCs to lung cancer cells in vitro were performed to evaluate the effect on PBMC cytokine expression. PBMC gene expression of CCL3, IL8 and IL1β was higher in lung cancer patients compared to the same patients at each of four sequential timepoints after removal of their tumors, while CXCL10 and IL2Rα were essentially unchanged. This pattern was also detected when lung cancer patients were compared to non-cancer patients. When non-cancer patients underwent surgery for benign diseases, these cytokine expression changes were not demonstrable. Lung cancer cell lines, but not benign bronchial epithelial cells, induced similar changes in cytokine gene and protein expression by healthy donor PBMCs in an in vitro co-culture system. We conclude that PBMCs from stage I lung cancer patients possess distinct cytokine expression patterns compared to both non-cancer patients, and lung cancer patients following tumor removal. These expression patterns are replicated by healthy donor PBMCs exposed to lung cancer cell lines, but not benign bronchial epithelial cells in vitro. These findings have implications for understanding the immune response to lung cancer.
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Affiliation(s)
- David H. Chang
- Center for Cancer Research and Genomic Medicine, The Daniel and Gloria Blumenthal Cancer Center, Paramus, New Jersey, United States of America
| | - John R. Rutledge
- Center for Cancer Research and Genomic Medicine, The Daniel and Gloria Blumenthal Cancer Center, Paramus, New Jersey, United States of America
| | - Ankur A. Patel
- Center for Cancer Research and Genomic Medicine, The Daniel and Gloria Blumenthal Cancer Center, Paramus, New Jersey, United States of America
| | - Barbara G. Heerdt
- Center for Cancer Research and Genomic Medicine, The Daniel and Gloria Blumenthal Cancer Center, Paramus, New Jersey, United States of America
| | - Leonard H. Augenlicht
- Albert Einstein Cancer Center, Montefiore Medical Center, Bronx, New York, New York, United States of America
| | - Robert J. Korst
- Center for Cancer Research and Genomic Medicine, The Daniel and Gloria Blumenthal Cancer Center, Paramus, New Jersey, United States of America
- Division of Thoracic Surgery, Department of Surgery, The Valley Hospital, Ridgewood, New Jersey, United States of America
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Suneja G, Shiels MS, Melville SK, Williams MA, Rengan R, Engels EA. Disparities in the treatment and outcomes of lung cancer among HIV-infected individuals. AIDS 2013; 27:459-68. [PMID: 23079809 PMCID: PMC3595594 DOI: 10.1097/qad.0b013e32835ad56e] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES HIV-infected people have elevated risk for lung cancer and higher mortality following cancer diagnosis than HIV-uninfected individuals. It is unclear whether HIV-infected individuals with lung cancer receive similar cancer treatment as HIV-uninfected individuals. DESIGN/METHODS We studied adults more than 18 years of age with lung cancer reported to the Texas Cancer Registry (N = 156 930) from 1995 to 2009. HIV status was determined by linkage with the Texas enhanced HIV/AIDS Reporting System. For nonsmall cell lung cancer (NSCLC) cases, we identified predictors of cancer treatment using logistic regression. We used Cox regression to evaluate effects of HIV and cancer treatment on mortality. RESULTS Compared with HIV-uninfected lung cancer patients (N = 156 593), HIV-infected lung cancer patients (N = 337) were more frequently young, non-Hispanic black, men, and with distant stage disease. HIV-infected NSCLC patients less frequently received cancer treatment than HIV-uninfected patients [60.3 vs. 77.5%; odds ratio 0.39, 95% confidence interval (CI) 0.30-0.52, after adjustment for diagnosis year, age, sex, race, stage, and histologic subtype]. HIV infection was associated with higher lung cancer-specific mortality (hazard ratio 1.34, 95% CI 1.15-1.56, adjusted for demographics and tumor characteristics). Inclusion of cancer treatment in adjusted models slightly attenuated the effect of HIV on lung cancer-specific mortality (hazard ratio 1.25; 95% CI 1.06-1.47). Also, there was a suggestion that HIV was more strongly associated with mortality among untreated than among treated patients (adjusted hazard ratio 1.32 vs. 1.16, P-interaction = 0.34). CONCLUSION HIV-infected NSCLC patients were less frequently treated for lung cancer than HIV-uninfected patients, which may have affected survival.
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Affiliation(s)
- Gita Suneja
- Department of Radiation Oncology, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Abstract
The greatest risk by far for developing lung cancer is cigarette smoking, but age, radon exposure, environmental pollution, occupational exposures, gender, race, and pre-existing lung disease also are important contributors. However, not all people with these risk factors develop lung cancer, and some without any known risk factor do, indicating the importance of genetic influences. Future advances in understanding and treating lung cancer will be based on genetic analysis. The most effective preventive measure is to never start or to stop cigarette smoking.
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Affiliation(s)
- Patricia de Groot
- Division of Diagnostic Imaging, Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1478, Houston, TX 77030, USA.
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Tumor-induced CD8+ T-cell dysfunction in lung cancer patients. Clin Dev Immunol 2012; 2012:741741. [PMID: 23118782 PMCID: PMC3483679 DOI: 10.1155/2012/741741] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 08/28/2012] [Accepted: 09/04/2012] [Indexed: 12/21/2022]
Abstract
Lung cancer is the leading cause of cancer deaths worldwide and one of the most common types of cancers. The limited success of chemotherapy and radiotherapy regimes have highlighted the need to develop new therapies like antitumor immunotherapy. CD8+ T-cells represent a major arm of the cell-mediated anti-tumor response and a promising target for developing T-cell-based immunotherapies against lung cancer. Lung tumors, however, have been considered to possess poor immunogenicity; even so, lung tumor-specific CD8+ T-cell clones can be established that possess cytotoxicity against autologous tumor cells. This paper will focus on the alterations induced in CD8+ T-cells by lung cancer. Although memory CD8+ T-cells infiltrate lung tumors, in both tumor-infiltrating lymphocytes (TILs) and malignant pleural effusions, these cells are dysfunctional and the effector subset is reduced. We propose that chronic presence of lung tumors induces dysfunctions in CD8+ T-cells and sensitizes them to activation-induced cell death, which may be associated with the poor clinical responses observed in immunotherapeutic trials. Getting a deeper knowledge of the evasion mechanisms lung cancer induce in CD8+ T-cells should lead to further understanding of lung cancer biology, overcome tumor evasion mechanisms, and design improved immunotherapeutic treatments for lung cancer.
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Jin J, Deng J, Wang F, Xia X, Qiu T, Lu W, Li X, Zhang H, Gu X, Liu Y, Cao W, Shao W. The expression and function of microRNA-203 in lung cancer. Tumour Biol 2012; 34:349-57. [PMID: 23073851 DOI: 10.1007/s13277-012-0556-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 10/04/2012] [Indexed: 12/19/2022] Open
Abstract
We aimed to determine the expression of microRNA-203 (miR-203) in human lung cancer cell lines and to evaluate the effects of miR-203 by targeting survivin, on the lung cancer cell line 95-D to provide potential new strategies for treating lung cancer. The expression of miR-203 was detected using quantitative real-time PCR (qRT-PCR) in the in vitro cultured lung cancer cells A549, HCC827, NCI-H1299, and 95-D as well as in normal human bronchial epithelial cells. Following a 72-h transfection with the miR-203 precursor in 95-D lung cancer cells, the change in miR-203 expression was detected using qRT-PCR and the resulting effect on survivin protein expression was ascertained by Western blot analysis. The influence of miR-203 on the viability of 95-D lung cancer cells was evaluated using 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. The effect of miR-203 on 95-D cell proliferation was analyzed using flow cytometry. The consequences of miR-203 expression on 95-D cell apoptosis were analyzed by Annexin V/propidium iodide double staining coupled with flow cytometry. The role of miR-203 in the invasive potential of 95-D cells was studied using a transwell chamber assay. A luciferase reporter gene system was used to verify that survivin is a target gene for miR-203. By qRT-PCR, the expression of miR-203 was lower in lung cancer cells than in normal bronchial epithelial cells (p < 0.01), and the expression of miR-203 in 95-D lung cancer cells was significantly higher after a 72-h transfection with the miR-203 precursor (p < 0.01). After a 72-h transfection with the miR-203 precursor, survivin protein levels in 95-D cells were significantly decreased (p < 0.01). Cell viability, as assessed with an MTT assay, decreased following an increase in miR-203 expression (p < 0.05). The flow cytometry results indicated that after miR-203 expression increased, the cell proliferation index decreased (p < 0.05) and the number of apoptotic cells increased (p < 0.01). Increased miR-203 expression led to a significant decrease in the number of cells that migrated through a transwell chamber membrane (p < 0.01). The luciferase reporter gene system demonstrated that the relative luciferase activity significantly decreased after transfection with the miR-203 precursor (p < 0.05). The expression of miR-203 is downregulated in lung cancer cells. miR-203 negatively regulates survivin protein expression and inhibits the proliferation and invasion of lung cancer cells. Therapeutic strategies that enhance miR-203 expression or silence survivin could potentially benefit lung cancer patients.
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Affiliation(s)
- Jianhua Jin
- Department of Medical Oncology, Wujin People's Hospital, Jiangsu University, No. 2, North Yongning Rd, Changzhou, 213002, People's Republic of China
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Liang JA, Sun LM, Muo CH, Sung FC, Chang SN, Kao CH. Non-apnea sleep disorders will increase subsequent liver cancer risk--a nationwide population-based cohort study. Sleep Med 2012; 13:869-74. [PMID: 22503943 DOI: 10.1016/j.sleep.2012.02.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 02/13/2012] [Accepted: 02/14/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION It is well known that patients with sleep disorders (SD) have an increased risk of cardiovascular disease, diabetes mellitus, obesity, and total mortality. However, little information exists regarding the relationship between non-apnea SD and the risk of cancer. The goal of this study was to determine if any association between SD and malignancy exists in Taiwan. METHODS We used data from the National Health Insurance system of Taiwan to assess this issue. The SD cohort contained 42,351 patients, and each patient was randomly frequency-matched by age and sex with two people from the general population without SD. The Cox's proportional hazard regression analysis was conducted to estimate the effects of SD on cancer risk. RESULTS In patients with SD, the overall risk of developing cancer was significantly higher than in normal healthy subjects (adjusted Hazard ratio [HR]=1.12, 95% confidence interval=1.06-1.18). This held true even when we analyzed males and females separately. In regards to individual types of cancer, the risk for developing liver cancer among patients with SD was significantly higher than in subjects without SD. For breast cancer the risk showed a marginally significant increase. CONCLUSION The nationwide population-based cohort study found Taiwanese patients with SD have a higher risk of developing cancer, particularly liver cancer and, possibly, breast cancer.
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Affiliation(s)
- Ji-An Liang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
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Okuma Y, Yanagisawa N, Takagi Y, Hosomi Y, Suganuma A, Imamura A, Iguchi M, Okamura T, Ajisawa A, Shibuya M. Clinical characteristics of Japanese lung cancer patients with human immunodeficiency virus infection. Int J Clin Oncol 2011; 17:462-9. [PMID: 21918928 DOI: 10.1007/s10147-011-0316-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Accepted: 08/18/2011] [Indexed: 01/12/2023]
Abstract
BACKGROUND Lung cancer has emerged as a crucial problem among human immunodeficiency virus (HIV)-infected patients, contributing to significant mortality in Western countries. Japan has an increasing number of newly infected HIV patients, but clinical characteristics of lung cancer have not been well investigated in Asian populations with HIV. PATIENTS AND METHODS We retrospectively analyzed patients diagnosed with HIV and lung cancer simultaneously in our institution between 1985 and 2010. Data regarding HIV status, characteristics, treatment, and prognosis of lung cancer were evaluated. RESULTS We identified 13 consecutive patients (all men; mean age, 59.0 ± 10.2 years) since 1985, 7 of whom had been diagnosed since 2008. Mean CD4 cell count was 332 ± 159 cells/μL, and HIV viral loads were undetectable in 8 patients (61.5%) at the time of lung cancer diagnosis. The mean latency from HIV diagnosis to detection of lung cancer was 4.0 years. Histological examination demonstrated adenocarcinoma in 9 patients (69.2%), followed by squamous cell carcinoma (23.1%), and small cell carcinoma (7.7%). Among the 7 patients available for examination, 2 patients (28.6%) harbored EGFR mutation. Six patients had stage IA-IIIA, and 7 patients had stage IIIB/IV. Among 6 patients treated with chemotherapy for unresectable stages, 5 (83.3%) achieved a partial response. Median overall survival was 17 months for all stages and 14 months for advanced stages. Toxicities for treatment modalities were largely acceptable. CONCLUSIONS Clinical characteristics of Japanese HIV-infected patients with lung cancer resemble those of Western populations. The prognosis for patients in the metastatic stage was better than previously reported.
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Affiliation(s)
- Yusuke Okuma
- Department of Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo, Tokyo 113-8677, Japan.
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Lung Cancer: An Emerging Epidemic in the human immunodeficiency virus-Infected Population. J Thorac Oncol 2010; 5:1721-3. [DOI: 10.1097/jto.0b013e3181f7c78f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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