The impact of androgen deprivation therapy on COVID-19 illness in men with prostate cancer Journal Article
| Authors: | Shah, N. J.; Patel, V. G.; Zhong, X.; Pina, L.; Hawley, J. E.; Lin, E.; Gartrell, B. A.; Adorno Febles, V.; Wise, D. R.; Qin, Q.; Mellgard, G.; Joshi, H.; Nauseef, J. T.; Green, D. A.; Vlachostergios, P. J.; Kwon, D. H.; Huang, F.; Liaw, B.; Tagawa, S.; Kantoff, P.; Morris, M. J.; Oh, W. K. |
| Article Title: | The impact of androgen deprivation therapy on COVID-19 illness in men with prostate cancer |
| Abstract: | Background: TMPRSS2, a cell surface protease regulated by androgens and commonly upregulated in prostate cancer (PCa), is a necessary component for SARS-CoV-2 viral entry into respiratory epithelial cells. Previous reports suggested a lower risk of SARS-CoV-2 among PCa patients on androgen deprivation therapy (ADT). However, the impact of ADT on severe COVID-19 illness is poorly understood. Methods: We performed a multicenter study across 7 US medical centers and evaluated patients with PCa and SARS-CoV-2 detected by polymerase-chain-reaction between March 1, 2020, and May 31, 2020. PCa patients were considered on ADT if they had received appropriate ADT treatment within 6 months of COVID-19 diagnosis. We used multivariable logistic and Cox proportional-hazard regression models for analysis. All statistical tests were 2-sided. Results: We identified 465 PCa patients (median age = 71 years) with a median follow-up of 60 days. Age, body mass index, cardiovascular comorbidity, and PCa clinical disease state adjusted overall survival (hazard ratio [HR] = 1.16, 95% confidence interval [CI] = 0.68 to 1.98, P = .59), hospitalization status (HR = 0.96, 95% CI = 0.52 to 1.77, P = .90), supplemental oxygenation (HR 1.14, 95% CI = 0.66 to 1.99, P = .64), and use of mechanical ventilation (HR = 0.81, 95% CI = 0.25 to 2.66, P = .73) were similar between ADT and non-ADT cohorts. Similarly, the addition of androgen receptor-directed therapy within 30 days of COVID-19 diagnosis to ADT vs ADT alone did not statistically significantly affect overall survival (androgen receptor-directed therapy: HR = 1.27, 95% CI = 0.69 to 2.32, P = .44). Conclusions: In this retrospective cohort of PCa patients, the use of ADT was not demonstrated to influence severe COVID-19 outcomes, as defined by hospitalization, supplemental oxygen use, or death. Age 70 years and older was statistically significantly associated with a higher risk of developing severe COVID-19 disease. |
| Keywords: | activation; sars-cov-2 |
| Journal Title: | JNCI Cancer Spectrum |
| Volume: | 6 |
| Issue: | 3 |
| ISSN: | 2515-5091 |
| Publisher: | Oxford University Press |
| Date Published: | 2022-06-01 |
| Start Page: | pkac035 |
| Language: | English |
| ACCESSION: | WOS:000805563900002 |
| DOI: | 10.1093/jncics/pkac035 |
| PROVIDER: | wos |
| PMCID: | PMC9165550 |
| PUBMED: | 35657341 |
| Notes: | Article -- pkac035 -- Source: Wos |
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