Androgen Deprivation Therapy May Be Protective Against COVID-19

Men with prostate cancer who are treated with androgen-deprivation therapy (ADT) had a significantly decreased risk of contracting SARS-CoV-2, the virus that causes the coronavirus disease 2019 (COVID-19), according to an Italian study published in the Annals of Oncology.¹

Researchers gathered data from 9,280 SARS-CoV-2—positive patients in Veneto, Italy — a region greatly impacted by the epidemic. Of these patients, men were more likely to develop severe complications, be hospitalized, and have worse clinical outcomes than their female counterparts, despite the fact that women were more likely to test positive for the infection.

Cancer Impacts Infection Rates, Severe Complications

Patients with cancer had a slightly higher rate of infection than those without cancer (0.3% of men versus 0.2% of men, respectively).

“In summary, our data indicate that male cancer patients have an increased risk of SARS-CoV-2 infection and develop more severe forms of COVID-19, in line with a recent study,” the authors wrote.

A Silver Lining for Men With Prostate Cancer

However, when the researchers compared the SARS-CoV-2—positive group to men with prostate cancer receiving ADT, the latter had a much lower rate of infection.

Further, an even larger difference was found in SARS-CoV-2 infection rate between patients with prostate cancer and patients with any other kind of cancer.

“Strikingly, only 4 out of the 5273 patients receiving ADT in Veneto developed SARS-CoV2-infection and none of these patients died,” the authors wrote. “Altogether, these data indicate that androgen deprivation in prostate cancer patients is associated with a reduced probability to develop SARS-CoV-2 infections with more positive infection outcomes.

Scientific Theory Behind the Benefit

Androgen receptors (ARs) regulate the TMPRSS2 protein. Previous in vitro studies have shown that TMPRSS2 inhibition — which occurs with ADT – may be beneficial in preventing SARS-CoV-2 infection.

“The evidence that ARs regulate TMPRSS2 expression in non-prostatic tissues, including lung, may explain the increased susceptibility of men to SARS-CoV-2 severe infections,” the authors wrote. “This suggests novel potential therapeutic interventions to treat COVID-19—affected people.”

While the findings may lead to a potential future breakthrough, the researchers admitted that more work still needs to be done. Particularly, their findings should be validated in another large study.

Reference

Montopoli M, Zumerle S., Vettor R. et. al. Androgen-deprivation therapies for prostate cancer and risk of infection by SARS-CoV-2: a population-based study. Annals of Oncology. May 6, 2020. DOI:https://doi.org/10.1016/j.annonc.2020.04.479