SARS-CoV-2 and Prostate Cancer: Is ADT Protective Against Infection?
Posted: Thursday, October 29, 2020
The focus of androgen-deprivation therapy (ADT) in the treatment of prostate cancer is the downregulation of the transmembrane protease, serine 2 (TMPRSS2) gene, which is upregulated in response to androgens in prostate cells. SARS-CoV-2 requires TMPRSS2 for pathogenesis. A recent report from the Veneto region of Italy hypothesized that ADT might have a protective effect for SARS-CoV-2 cell entry by suppressing an androgen-regulated co-factor. However, Lara Jehi, MD, of the Cleveland Clinic, Ohio, and colleagues found that ADT did not seem to be protective against SARS-CoV-2 infection. Their results were published in The Journal of Urology.
The research team began collecting data on all patients tested for SARS-CoV-2 in their health system in March 2020. The total tested population included 74,787 patients, of whom 6.5% (n = 4,885) tested positive for SARS-CoV-2. Among the total patient population, 1,779 patients with prostate cancer were identified; 102 tested positive for SARS-CoV-2 and 304 were receiving ADT. Most of the known risk factors for infection and mortality were equally distributed, and there seemed to be no difference in the rates of infection in men with prostate cancer who had or did not have ADT. They noted that patients receiving ADT were older, more likely to have smoked, and reported taking steroids, all of which challenge the theory that ADT may protect against SARS-CoV-2.
The researchers concluded: “In men with prostate cancer, ADT did not protect against SARS-CoV-2 infection,” and “routine use of ADT is not warranted in the absence of clinical trials.”
Disclosure: The study authors reported no conflicts of interest.