Severe-COVID-19 and mortality among patients (pts) with prostate cancer (PCa) receiving androgen deprivation therapy (ADT).

Authors

null

Matthew D Tucker

Vanderbilt University Medical Center, Nashville, TN

Matthew D Tucker , Andrew Lachlan Schmidt , Chih-Yuan Hsu , Yu Shyr , Andrew J. Armstrong , Ziad Bakouny , Christina Hunter Chapman , Scott Dawsey , Benjamin Adam Gartrell , Susan Halabi , Monika Joshi , Ali Raza Khaki , Harry Menon , Matthew Puc , Nima Sharifi , Justin Shaya , Elizabeth Marie Wulff-Burchfield , Tian Zhang , Shilpa Gupta , Rana R. McKay

Organizations

Vanderbilt University Medical Center, Nashville, TN, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, MA, Duke University Medical Center, Durham, NC, Mercy Med Ctr, Baltimore, MD, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, Penn State Cancer Institute, Hershey, PA, University of Washington, Seattle, WA, Virtua Surgical Group, Marlton, NJ, Cleveland Clinic, Cleveland, OH, University of California San Diego, Moores Cancer Center, La Jolla, CA, University of Kansas Medical Center, Westwood, KS

Research Funding

No funding received
None

Background: The presence of progressing cancer, male sex and advanced age have been shown to increase the severity of coronavirus disease 2019 (COVID-19). Given that the androgen regulated gene TMPRSS2 has been implicated in SARS-CoV-2 viral entry, we hypothesized that ADT may improve COVID-19 outcomes. This analysis evaluated clinical outcomes of pts with PCa with concurrent SARS-CoV-2 infection and investigated the impact of ADT on occurrence of severe-COVID-19 and mortality. Methods: Data was obtained via the COVID-19 and Cancer Consortium (CCC19), a multicenter registry including >120 cancer centers with de-identified data from pts with COVID-19 and cancer. Men with confirmed SARS-CoV-2 infection and a primary diagnosis of prostate cancer were included: data cutoff of July 31, 2020. The primary endpoint was the development of severe-COVID-19 (death, ICU admission, or mechanical ventilation) among pts on ADT vs. those not on ADT at time of COVID-19 infection. Secondary endpoints included 30-day mortality based on ADT use. Mortality and development of severe-COVID-19 were assessed in Pts grouped by therapy: 1st generation androgen receptor inhibitor (ARI-1), 2nd generation ARI (darolutamide, enzalutamide, apalutamide, ARI-2), abiraterone/prednisone, and chemotherapy. Propensity score matching was utilized. Logistic regression was utilized to adjust for age, ECOG PS, comorbidities, and race. Results: 589 pts were included; median follow-up was 42 days (IQR 25-90) and 62% (363/589) were hospitalized. Severe-COVID-19 developed in 28% of pts and the all-cause 30-day mortality rate was 19%. There was no significant difference in the development of severe-COVID-19 or 30-day mortality between Pts on ADT vs not on ADT, whether using descriptive statistics with the entire population or using the propensity score matched population (Table). Among the descriptive population, the numerical rates of severe-COVID-19 and mortality were lowest in Pts receiving ARI-2, but sample size was low. Conclusions: The overall 30-day mortality rate and percentage developing severe-COVID-19 were high. There was no statistical difference in the development of severe-COVID-19 or mortality based on receipt of ADT; however, this analysis is limited by the retrospective nature and small N after propensity-matching.

UnmatchedTotal (N=589)No ADT
(N=450)
ADT
(N=139)
P valueARI-1
(N=26)
ARI-2
(N=20)
Abiraterone
(N=25)
Chemotherapy
(N=12)
Severe COVID-19 N (%)162 (28)119 (26)43 (31)P=0.30014 (54)4 (20)11 (44)5 (42)
30- day Mortality N (%)112 (19)78 (17)34 (24)P=0.06111 (42)2 (10)8 (32)3 (25)
Median Age (range), years74 (43-90)73 (49-90)76 (43-90)P=0.21378 (45-90)76 (57-90)80 (65-90)68 (43-89)
Propensity Score MatchedTotal
(N= 224)
No ADT (N= 138)ADT
(N= 86)
P value
Severe COVID-19 N (%)65 (29)39 (28)26 (30)P=0.752
30- day Mortality N (%)44 (20)23 (17)21 (24)P=0.156

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Abstract Details

Meeting

2021 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session: Prostate Cancer - Advanced Disease

Track

Prostate Cancer - Advanced

Sub Track

Impact of COVID-19

Citation

J Clin Oncol 39, 2021 (suppl 6; abstr 39)

DOI

10.1200/JCO.2021.39.6_suppl.39

Abstract #

39

Poster Bd #

Online Only

Abstract Disclosures