Can ARDT Protect Against Poor Outcomes of COVID-19?

The following article features coverage from the ASCO Genitourinary Cancers Symposium 2022. Click here to read more of Cancer Therapy Advisor’s conference coverage.

Results from a new study do not clarify whether androgen receptor-directed therapy (ARDT) can prevent poor outcomes in patients with prostate cancer and COVID-19.

Most outcomes were numerically better in patients who received ARDT compared with those who did not, but there were no significant differences between the treatment groups.

Researchers reported these results in a poster at the ASCO Genitourinary Cancers Symposium 2022.¹

The researchers noted that SARS-CoV-2 requires the activity of TMPRSS2 for entry into host cells, the androgen receptor regulates TMPRSS2, and ARDT is known to decrease the expression of TMPRSS2. In addition, a prior study suggested that proxalutamide, an androgen receptor antagonist, can reduce the rate of COVID-19 hospitalization.²

With this in mind, the researchers conducted a retrospective study to determine if ARDT can decrease the risk of poor outcomes from COVID-19 among patients with prostate cancer.¹

The study included data from 146 patients with prostate cancer who were diagnosed with COVID-19 between March and October 2020.

The researchers compared 25 patients who were receiving ARDT with 121 patients who were not. Types of ARDT included gonadotropin-releasing hormone (GnRH) agonists, GnRH antagonists, and androgen receptor antagonists.

At baseline, the mean age was 78.4 years in the ARDT group and 77.2 years in the non-ARDT group. The proportion of patients with metastasis was 48% and 5%, respectively (P <.0001).

Results

The rate of hospitalization was the same in both groups, at 52%. However, the mean length of hospital stay was numerically shorter in the ARDT group than in the non-ARDT group — 9.2 days and 14.9 days, respectively (P =.14).

Additionally, the proportion of patients who were in the hospital for at least 30 days was numerically higher in the non-ARDT group than in the ARDT group — 14.29% and 0%, respectively (P =.15)

Intubation was required in 11.1% of patients in the non-ARDT group but none of those in the ARDT group (P =.21). The mortality rate was 8% in the ARDT group and 13.2% in the non-ARDT group (P =.47).

“Despite advanced stage of the cancer in the ARDT group, the length of hospitalization, rates of prolonged hospitalization, intubation, and mortality were numerically smaller in the ARDT group than in the non-ARDT group,” the researchers noted.

They added that this study was limited by its small sample size and retrospective nature. Therefore, results from prospective trials “are eagerly awaited.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Read more of Cancer Therapy Advisor’s coverage of ASCO GU 2022 by visiting the conference page.

References

1. Unlu S, Shin JJ, Par-Young J, et al. Effect of androgen receptor directed therapy in prostate cancer patients with COVID-19. Presented at ASCO GU 2022; February 17-19, 2022. Abstract 161.
2. McCoy J, Goren A, Cadegiani FA, et al. Proxalutamide reduces the rate of hospitalization for COVID-19 male outpatients: A randomized double-blinded placebo-controlled trial. Front Med. 2021;8:668698. doi:10.3389/fmed.2021.668698