Impact of androgen deprivation therapy on mortality of prostate cancer patients with COVID-19: a propensity score-based analysis

Author(s)

Duarte, Mateus Bringel Oliveira ^{[1, 2]} ; Leal, Frederico ^[1] ; Argenton, Juliana Luz Passos ^[3] ; Carvalheira, Jose Barreto Campello ^[1]

Affiliation

^[1] State Univ Campinas UNICAMP, Sch Med Sci, Div Oncol, Dept Anesthesiol, Campinas, SP - Brazil

^[2] Fed Univ Iandia, Uberlandia Canc Hosp, UFU, Uberlandia, MG - Brazil

^[3] Univ Estadual Campinas FUNCAMP, Fundacao Desenvolvimento, Campinas, SP - Brazil

• Document type: Journal article
• Source: INFECTIOUS AGENTS AND CANCER; v. 16, n. 1 NOV 25 2021.
• Web of Science Citations: 0

Abstract

Background Previous studies hypothesized that androgen deprivation therapy (ADT) may reduce severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infectivity. However, it is unknown whether there is an association between ADT and a higher survival in prostate cancer patients with COVID-19. Methods We performed a retrospective analysis of prostate cancer (PC) patients hospitalized to treat COVID-19 in Brazil's public health system. We compared patients with the active use of ADT versus those with non-active ADT, past use. We constructed propensity score models of patients in active versus non-active use of ADT. All variables were used to derive propensity score estimation in both models. In the first model we performed a pair-matched propensity score model between those under active and non-active use of ADT. To the second model we initially performed a multivariate backward elimination process to select variables to a final inverse-weight adjusted with double robust estimation model. Results We analyzed 199 PC patients with COVID-19 that received ADT. In total, 52.3% (95/199) of our patients were less than 75 years old, 78.4% (156/199) were on active ADT, and most were using a GnRH analog (80.1%; 125/156). Most of patients were in palliative treatment (89.9%; 179/199). Also, 63.3% of our cohort died from COVID-19. Forty-eight patients under active ADT were pair matched against 48 controls (non-active ADT). All patients (199) were analyzed in the double robust model. ADT active use were not protective factor in both inverse-weight based propensity score (OR 0.70, 95% CI 0.38-1.31, P = 0.263), and pair-matched propensity score (OR 0.67, 95% CI 0.27-1.63, P = 0.374) models. We noticed a significant imbalance in the propensity score of patients in active and those in non-active ADT, with important reductions in the differences after the adjustments. Conclusions The active use of ADT was not associated with a reduced risk of death in patients with COVID-19. (AU)

• FAPESP's process: 18/23428-0 - Metabolic profile characterization of sarcopenic patients with colorectal cancer
• Grantee: José Barreto Campello Carvalheira
• Support Opportunities: Regular Research Grants