Epidemiological profile of COVID-19 in patients with prostate cancer undergoing androgen deprivation therapy at a Brazilian Cancer Center

Abstract

Older individuals with cancer constitute a high-risk group for COVID-19. Entry of the virus into cells occurs through the binding of the S protein with angiotensin-converting enzyme 2, which is mediated by the TMPRSS2 gene and regulated by androgen receptors. Androgen deprivation therapy in patients with prostate cancer inhibits AR-TMPRSS2 interactions, which in turn inhibits the aggressiveness of the infection. We were unable to prove an association between the use of androgen deprivation therapy and a reduction in factors associated with worse clinical outcomes. Most of the data presented show a tendency to favor the outcomes of patients who do not undergo androgen deprivation therapy, which can be explained by the fact that, in general, their clinical conditions are better and their performance status scores are lower than those of patients who undergo androgen deprivation therapy. Abstract presented to the oncology department of A.C.Camargo Cancer Center as a conclusion of the Scientific Initiation. OBJECTIVE: To describe the epidemiological aspects of COVID-19 in patients with prostate cancer who received androgen deprivation therapy and those who did not. METHODS: We retrospectively analyzed the medical records of patients with prostate cancer undergoing androgen deprivation therapy and those who did not undergo androgen deprivation therapy. These patients were treated at the A.C.Camargo Cancer Center between March 2020 and March 2021. RESULTS: Of the 78 patients with prostate cancer and positive RT-PCR test results, 50% were undergoing androgen deprivation therapy, and 49% were experiencing a non-metastatic biochemical relapse. Of these, 80.6% were symptomatic on the day of examination compared to 97.2% in the Control Group. A total of 82.1% of the patients receiving androgen deprivation therapy required hospitalization, with 30.8% admitted to the intensive care unit compared to 21.6% in the Control Group. There was no statistically significant difference in the use of a high-flow oxygen cannula, the need for orotracheal intubation and mechanical ventilation, the need for dialysis, multiple organ failure, or death. A significant difference was found between the groups in terms of the average length of stay in the intensive care unit. CONCLUSION: Androgen deprivation therapy was not associated with protective factors or potential treatments in patients with prostate cancer and COVID-19. Although the number of patients analyzed was limited, and there may have been a selection bias, this is a unique study that cannot be expanded or replicated in similar (unvaccinated) populations.