Prostate Cancer and COVID-19: Is Hormonal Therapy a Protective or Risk Factor?
Posted: Wednesday, September 9, 2020
For patients with prostate cancer, further studies are needed to determine whether hormonal therapy, particularly in castration-resistant prostate cancer, has a positive or negative effect on infections with COVID-19, according to findings from an epidemiologic study presented in the journal Oncology. Sabino De Placido, MD, of the University Federico II, Naples, Italy, and colleagues focused on Italian patients with prostate cancer being treated with hormonal therapy or chemotherapy to provide a snapshot of the population during the pandemic.
“Reducing the dose of cancer therapy, interrupting treatment if the cancer is not an aggressive cancer, or changing treatment drugs could be options for the management of prostate cancer patients who are COVID-19–positive,” the authors concluded.
The authors focused on patients undergoing hormonal therapy or chemotherapy for prostate cancer; these patients received telephone and in-person pretriage in March 2020 at the Tortora Hospital in Pagani. There were 72 patients, of whom 48 had a hormone-sensitive disease and 24 had a castration-resistant disease.
Of the patients, two with the castration-resistant disease had COVID-19 (no patients with hormone-sensitive disease had the coronavirus). Both patients were receiving luteinizing hormone-releasing hormone agonist therapy, and one patient was receiving enzalutamide. Both patients were admitted to the urgent intensive care unit because of clinical worsening, and blood tests showed severe lymphopenia, anemia, and an increase in platelets.
At the start of treatment, the patients were prescribed retroviral therapy, antibiotics, heparin, and chloroquine; one patient also received tocilizumab as a salvage treatment. Both patients underwent aggressive treatment of the coronavirus because of concomitant comorbidities. After 3 weeks of hospitalization, both patients were discharged.
“Whether hormone therapy, especially in a castration-resistant prostate cancer setting, has a detrimental or beneficial effect during an aggressive course of COVID-19 remains unknown,” concluded the investigators.
Disclosure: The authors reported no conflicts of interest.