Paris (AFP)

Men with prostate cancer treated with anti-androgens, hormone therapy that lowers testosterone, are less likely to get the new coronavirus and develop a severe form of the disease, said an Italian study published Thursday.

The article in the monthly European Society for Medical Oncology (ESMO), Annals of Oncology, is the first to suggest an association between this treatment and Covid-19.

Researchers hypothesize that anti-androgen treatments may partially protect prostate cancer patients from the new coronavirus.

Cancer patients have an increased risk of becoming infected and developing severe forms of Covid-19, they point out.

Their hypothesis is based on recent research that a protein called TMPRSS2 helps the virus to infect human cells. The levels of this protein are under the control of androgens in the prostate but also in the lungs.

This could explain why men infected with the new coronavirus develop a more aggressive form of the disease than women, according to Professor Andrea Alimonti, of the Università della Svizzera Italiana (Bellinzona, Switzerland).

Out of 4,532 men in the Veneto region of Italy, infected with the new coronavirus, 9.5% had cancer and 2.6% had prostate cancer.

Male cancer patients had a 1.8-fold higher risk of infection than the general male population and developed more severe disease. However among all the cases of prostate cancer in this region particularly affected by the epidemic, only four of the 5,273 men on anti-androgen treatment developed the infection and none died.

According to Professor Alimonti, the risk of developing the infection was four times lower in these patients than in those who did not receive anti-androgen therapy. The risk was five times less likely to develop a serious form for prostate cancer cases on antiandrogens compared to any other type of cancer.

The researchers thus evoke the possibility of a "limited" use (one month for example) of anti-androgens, whose effects are reversible, to prevent infection with Covid-19 in men.

One effect of hormone therapy for prostate cancer is impotence, notes Professor Fabrice André, director of research at the Gustave Roussy Institute (IGR, France) who advises against using it before clinical trials confirm its efficiency.

According to this oncologist, editor of the Annals of Oncology, this study provides a reason to evaluate the effectiveness of treatment against Covid-19, "but does not allow us to conclude on its role in patients infected with the coronavirus".

Several studies around the world (France, United Kingdom, United States) on hospitalized cancer patients are underway and will say if they confirm this Italian observation, he told AFP. "If all the data (including laboratory tests at the IGR) are convergent, clinical trials could begin".

© 2020 AFP