The vulnerable group
As we know COVID-19 has drastically changed the landscape of the healthcare system and how a pandemic can truly shift target groups. COVID-19 is caused by rapid spread of acute respiratory syndrome. According to the COVID 19 data in motion, the virus has contributed to more than 440,000 deaths. This data continues to change. However, something that remains the same is the most vulnerable groups which includes individuals with comorbidities and older age. Prostate cancer patients typically fall in this high-risk population, including men are impacted at greater rates for COVID-19 disease. Another important factor, documented by the Journal of Clinical Oncology states approximately 18% of prostate cancer patients have multiple comorbidities. Researchers at the Department of Urology and The Tisch Cancer Institute decided to examine sex differences and links to prostate cancer.
Commodities play a major role in increases the risk of COVID-19 and severity. Commodities including but not limited to diabetes, hypertension, alcoholism, and active smoking. These same factors of COVID-19 are also linked to prostate cancer susceptibility, progression, and outcomes. Interestingly, the most common risk factor for both diseases is age. According to Nature Reviews Urology, systemic or tissue derived inflammation, during COVID-19, has the potential to accelerate pre-existing prostate cancer resulting in an aggressive phenotype and therefore represents a potential risk factor for prostate cancer patients.
In conclusion, clinical trials are still trying to understand the exact impact of COVID-19 on prostate cancer patients but through the close correlations of risk factors there in a defined link between COVID-19 and Prostate Cancer. The future of clinical trials will look at the repurposing of existing drugs. The Department of Urology and The Tisch Cancer Institute is currently exploring the feasibility of a clinical trial of nasal Poly-ICLC (Hiltonol®) for COVID-19 in men (age group ≥40) who are at high risk of contracting COVID-19 and with factors/comorbidities associated with higher mortality. An ongoing dose-escalation study (NCT03262103) to determine a safe dose and schedule of intratumoral (IT) plus intramuscular (IM) Poly-ICLC (Hiltonol®) injections prior to radical prostatectomy in patients with prostate cancer has shown that it was well tolerated in patients at high risk of recurrence (n = 6; Cohorts 1&2) (Chakravarty et al., 2020).