Background:Although the relationship between androgen deprivation therapy (ADT) for prostate cancer (PC) and the biological mechanisms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unequivocally unclear, it is possible that exposure to the virus may influence PC evolution by altering TMPRSS2 expression. This study aims to evaluate the long-term oncological outcomes of patients with metastatic PC who were undergoing medical therapy at the time of contracting SARS-CoV-2 and who resumed/continued anticancer treatment after recovery.Methods:We retrospectively evaluated a consecutive series of 151 metastatic PC patients who developed SARS-CoV-2 infection while receiving one active systemic anticancer therapy (125 metastatic castration-resistant PC (mCRPC) patients and 26 metastatic hormone-sensitive PC (mHSPC) patients). We evaluated variables that influence the ability to maintain or resume the ongoing therapy. For the maintained/resumed therapies, we calculated the post-infection overall survival (piOS) and the overall survival (OS).Results:Of the patients, 12.6% died due to SARS-CoV-2 infection, 10.6% recovered from the infection but failed to maintain/resume the ongoing anticancer treatment, and the remaining 76.8% maintained/resumed the treatment after recovery. Hospitalization, duration of infection, and the type of ongoing anticancer agent influenced these treatment changes. In the cohort of mCRPC patients, the median piOS was 32 months, and the median OS was 67.8 months. The median piOS was not achieved in the cohort of mHSPC patients, while the median OS was 122 months. The outcomes of single anticancer agents were in line with those of pivotal trials.Conclusions:Although observed in a highly selected population of PC patients who survived SARS-CoV-2 infection and were able to resume/maintain anticancer therapy, the survival outcomes of this study appear to be in line with those reported in pivotal studies, and SARS-CoV-2 infection does not seem to have adversely affected long-term oncological outcomes.
背景：尽管前列腺癌（PC）的雄激素剥夺疗法（ADT）与严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染的生物学机制间的关系仍不完全明确，但病毒感染可能通过改变TMPRSS2表达影响前列腺癌的进展。本研究旨在评估转移性前列腺癌患者在感染SARS-CoV-2期间接受药物治疗，并在康复后恢复/继续抗癌治疗的长期肿瘤学结局。
方法：我们回顾性分析了151例在接受系统抗癌治疗期间感染SARS-CoV-2的连续性转移性前列腺癌患者（其中125例为转移性去势抵抗性前列腺癌（mCRPC），26例为转移性激素敏感性前列腺癌（mHSPC）），评估了影响患者维持或恢复原有治疗能力的相关因素。对于维持/恢复治疗的患者，计算了感染后总生存期（piOS）和总生存期（OS）。
结果：12.6%的患者死于SARS-CoV-2感染，10.6%的患者康复但未能维持/恢复原有抗癌治疗，其余76.8%的患者在康复后维持/恢复了治疗。住院情况、感染持续时间及抗癌药物类型是影响治疗改变的因素。在mCRPC患者队列中，中位piOS为32个月，中位OS为67.8个月；mHSPC患者队列未达到中位piOS，中位OS为122个月。各类抗癌药物的治疗效果与关键临床试验结果一致。
结论：尽管本研究针对的是感染SARS-CoV-2后存活并能恢复/维持抗癌治疗的前列腺癌患者群体，但其生存结局与关键研究报告的数据基本相符，SARS-CoV-2感染似乎未对长期肿瘤学结局产生负面影响。
肿瘤(癌症)患者之家