ADT May Offer Some Protection From COVID-19 in Men with Prostate Cancer

A PCF-funded study of men with prostate cancer in Italy suggests that men with prostate cancer who were taking ADT were 4 times less likely to be infected with the coronavirus than men who were not on ADT (androgen deprivation therapy), and 5 times less likely to die. These new findings are a game-changer and may lead to potential treatments for COVID-19, even in men without prostate cancer.

Prof. Andrea Alimonti and team looked at more than 9000 patients with confirmed COVID-19 infection in Veneto, Italy; they also used data on all cancer patients in the region for comparison. Among all prostate cancer patients, only 4 out of 5,273 men on ADT developed COVID-19 infection. None of the men died. Among 37,161 men with prostate cancer who were not receiving ADT, 114 developed COVID-19 and 18 died.

Why might this be? The coronavirus relies on a protein called TMPRSS2 to enter cells. Once inside the cell, the virus hijacks the cell’s protein-making machinery, churns out new copies of itself, and destroys the cell. TMPRSS2 is regulated by male hormones such as testosterone. Lower testosterone means lower levels of TMPRSS2 in the prostate. For years, PCF has been funding research on how TMPRSS2 could be leveraged to treat prostate cancer. The hope is that this accumulated knowledge on TMPRSS2 can be applied to COVID-19 in the lungs. ADT lowers testosterone, potentially decreasing the amount of TMPRSS2 on lung cells, and — as this study suggests – leading to lower infection rates and possibly less death among men with prostate cancer who are taking ADT.

A single dose of ADT — like a shot of Lupron or degarelix – may offer protection to men without prostate cancer who are infected with COVID-19. Clinical trials will soon be underway in the PCF-VA network at hospitals in LA, Seattle, and New York City. Other clinical trials have been launched in Denmark and Japan, and at other major medical centers in the US. From data discovery to the first patient with COVID-19 treated with PCF TMPRSS2 expertise took less than 5 weeks. This is an absolute historic first for speed of prostate cancer researchers turning to the fight against COVID-19.

Until the clinical trials are completed, no recommendations to give ADT to men with COVID-19 can be made. However, PCF will be a global platform for sharing all the anti-TMPRSS2 clinical trials aimed at COVID-19 for doctors and nurses caring for COVID-19 patients around the world. Go to PCF.org/COVID-19.

At this time, there are also no recommendations to give ADT to men with prostate cancer solely for COVID-19 protection. If you have prostate cancer, you should continue to follow your established treatment plan and take precautions such as frequent handwashing, not touching your face, and social distancing and wearing of face coverings as recommended by local public health guidelines.