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COVID-19 and Breast Cancer: Protective Role for Antiestrogen Therapies?

By: Sarah Campen, PharmD
Posted: Tuesday, February 16, 2021

According to a letter to the editor published in Annals of Oncology, women with breast and ovarian cancers appear to have an increased risk of SARS-CoV-2 infection. They may develop more severe forms of COVID-19 compared with women who do not have cancer. Of note, Arianna Calcinotto, PhD, of the IOR Institute of Oncology Research, Bellinzona, Switzerland, and colleagues reported that one group of women seemed to have a reduction in the prevalence of COVID-19—those with hormone-driven cancers who were being treated with selective estrogen receptors modulators (SERMs).

This retrospective study included 51,060 women tested for SARS-CoV-2 infection from February 22 to April 1, 2020; 2,478 of those tested had a clinical history of malignancy (4.9%), including 926 women with breast cancer and 60 with ovarian cancer. Women affected by cancer had a significantly higher prevalence of infection than those without cancer (13.4% vs. 9.1%, P < .001). The researchers also reported more frequent hospitalization (49.5% vs. 26.5%) and death (19.3% vs. 7.3%) in women with cancer versus those without.

A total of 483 patients affected by hormone-driven cancer were receiving antiestrogen therapies: 198 were treated with SERMs, 334 were given aromatase inhibitors, and 48 received luteinizing hormone–releasing hormone agonists. SARS-CoV-2 positivity was found in 14 women treated with SERMs (7.1%), 44 treated with aromatase inhibitors (13.2%), and 3 treated with luteinizing hormone–releasing hormone agonists (6.3%).

Of the women treated with one of the three categories of anti-estrogen therapies, only patients treated with SERMs had a lower prevalence of SARS-CoV-2 (hazard ratio = .42, 90% confidence interval = 0.21–0.83) as compared with patients not receiving any anti-estrogen therapy. “These data need to be further validated in a larger cohort and corrected to multiple variables,” concluded the authors.

Disclosure: The authors have reported no conflicts of interest.



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