The Impact of Androgen Deprivation Therapy on COVID-19 Illness in Men With Prostate Cancer

Neil J. Shah, Vaibhav G. Patel, Xiaobo Zhong, Luis Pina, Jessica E. Hawley, Emily Lin, Benjamin A. Gartrell, Victor Adorno Febles, David R. Wise, Qian Qin, George Mellgard, Himanshu Joshi, Jones T. Nauseef, David A. Green, Panagiotis J. Vlachostergios, Daniel H. Kwon, Franklin Huang, Bobby Liaw, Scott Tagawa, Philip KantoffMichael J. Morris, William K. Oh

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

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 ¼ 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] ¼ 1.16, 95% confidence interval [CI] ¼ 0.68 to 1.98, P ¼ .59), hospitalization status (HR ¼ 0.96, 95% CI ¼ 0.52 to 1.77, P ¼ .90), supplemental oxygenation (HR 1.14, 95% CI ¼ 0.66 to 1.99, P ¼ .64), and use of mechanical ventilation (HR ¼ 0.81, 95% CI ¼ 0.25 to 2.66, P ¼ .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 ¼ 1.27, 95% CI ¼ 0.69 to 2.32, P ¼ .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.

Original languageEnglish (US)
Article numberpkac035
JournalJNCI Cancer Spectrum
Volume6
Issue number3
DOIs
StatePublished - Jun 1 2022
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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