Androgen deprivation therapy for prostate cancer can protect men from COVID-19

A study of 4532 men in the Veneto region of Italy found that those who had been treated for prostate cancer with androgen deprivation therapy (ADT) were less likely to develop coronavirus COVID-19 and were infected. , The disease is not so serious.

Authors of studies published in leading cancer journals Oncology records Today, they say their findings suggest that ADT appears to protect men from COVID-19 infections.

Researchers led by Professor Andrea Arimonti of the University of Svezzara Italiana (Bellinzona, Switzerland) found that out of 4532 men infected with COVID-19, 9.5% (430) had cancer and 2.6% (118). )But Prostate cancer. Male cancer patients had a 1.8-fold increased risk of COVID-19 infection in the entire male population and developed more severe disease.

But when they see everything Prostate cancer patients In the Veneto region, they found that only 4 out of 5,273 men with ADT developed a COVID-19 infection and none of them died. This compares to 114 of 37,161 men with prostate cancer who did not receive ADT who developed COVID-19 and 18 died. Of 79,661 patients with other types of cancer, 312 developed COVID-19 and 57 died.

Professor Alimonti said: “Prostate cancer patients receiving androgen deprivation therapy have a four-fold reduced risk of COVID-19 infection compared to those who do not receive ADT. There was an even greater difference when compared to patients with other types of cancer; there was a more than 5-fold reduction in the risk of infection between patients with prostate cancer of ADT.

“This is the first paper suggesting a link between ADT and COVID-19. Collecting data from the majority of patients infected with coronaviruses and protecting all patients treated with ADT for prostate cancer Cancer has a higher risk of COVID-19 infection than non-cancer patients. “

Researchers say that even if men don’t get prostate cancer, people at high risk of developing COVID-19 can take ADT for a limited time to prevent infection, and infected people can reduce ADT. Researchers believe that suggests that the severity of the symptoms.

“There are several clinically approved treatments that lower androgen levels and can be administered to patients. For example, luteinizing hormone-releasing hormone, or LH-RH, antagonists lower patient testosterone levels in 48 hours. This treatment is transient, and when the patient stops taking the drug, testosterone levels return to their previous levels. These treatments that lower testosterone levels even if given within a month There are no major side effects, “said Professor Alimonti. .

“ We hope our findings will encourage other clinicians to use transient ADT in men infected with COVID-19 to conduct clinical trials in addition to other therapies. They provide the answer to the hypothesis that androgen levels can promote coronavirus infection and increase the severity of symptoms, as seen in male patients. ”

Professor Alimonti and co-workers show that ADT’s impact on vulnerabilities to COVID-19 this year after a recent study showed that a protein called TMPRSS2 helps COVID-19 infect healthy human cells. I started to investigate. TMPRSS2 is a member of a family of proteins called type II transmembrane serine proteases and is involved in many processes in the body, including cancer and viral infections. Prostate cancer patients have high levels of TMPRSS2, whose effects are regulated by androgen receptors and are targeted for treatments such as ADT. Androgen receptors also regulate TMPRSS2 levels in non-prostate tissues, including the lung.

“This can explain why men infected with COVID-19 develop more aggressive forms of disease than women,” said Alimonti. “It is known that ADT can reduce levels of TMPRSS2 in patients with prostate cancer, and some evidence has shown that it can occur not only in the prostate but also in other tissues. Therefore, I wanted to see if ADT reduces the risk of developing coronavirus. infection And in men prostate cancer. “

Researchers suggest that androgen deprivation therapy can be combined with other drugs that block the growth of viruses and infect human cells, or interfere with the activity of TMPRSS2 in the body.

Limitations of this study include the fact that cancer patients with COVID-19 are often hospitalized and may have been screened for viruses more than non-cancer patients. This may explain the high prevalence of coronaviruses in cancer patients. Prostate cancer patients undergoing ADT need to be more sensitive to social distances than those without ADT and other forms of the disease. cancer, Especially because ADT can be administered at home.

Editor-in-chief Oncology records, Said Fabris André, Principal Investigator at the Gustave Russie Institute in Villejuif, France. Studies provide no conclusive conclusions about the role of ADT in patients infected with COVID-19, and this class of drugs should be used for this purpose until a prospective study confirms its efficacy Not.