Kaposi's sarcoma (KS) develops in a variety of clinical settings and is the most common tumor seen in patients with HIV infection. KS develops most commonly in men compared to women (15:1) regardless of the clinical setting. It thus appears that sex hormones play a role in the pathogenesis of this disease. However the lack of sex hormone receptors in KS tissues argue against the direct effect of these hormones. Metabolic products of sex hormones which do not bind the receptors may have direct effects and will be discussed. The development and progression of KS secondary to the exogenous use of glucocorticoids has been reported in HIV infected and uninfected individuals. Furthermore the direct stimulatory effects of glucocorticoids enchance KS cell growth through the regulation of various growth regulatory factors. Lastly I will discuss the results of clinical trials of human chorionic gonadotrophin in the treatment of KS. These studies are based on the findings fo Drs. Lunardi-Iskandar, Bryant and Gallo (Nature374:64-68, 1995) who showed that KS cell lines do not propagate in pregnant mice, that hCG inhibits KS cell growth in vitro and in the mouse model. In collaboration with Dr. Gallo's group we have studied the direct effect of hCG in humans. HCG was injected directly in the tumor lesions in a dose escalating schema. Furthermore at the highest dose level tested (2,000 IU), a double blind trial comparing hCG is active. The details of the results will be presented.

Antineoplastic Agents, Hormonal/*THERAPEUTIC USE Female Glucocorticoids/*THERAPEUTIC USE HIV Infections/COMPLICATIONS Human Male Sarcoma, Kaposi's/ETIOLOGY/*THERAPY Sex Hormones/*THERAPEUTIC USE ABSTRACT

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