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. 2022 Jun 30;14(13):3206.
doi: 10.3390/cancers14133206.

Concurrent Androgen Deprivation Therapy for Prostate Cancer Improves Survival for Synchronous or Metachronous Non-Small Cell Lung Cancer: A SEER-Medicare Database Analysis

Bassel Nazha  1 , Chao Zhang  2 , Zhengjia Chen  3   4 , Camille Ragin  5 , Taofeek K Owonikoko  6
Affiliations

Concurrent Androgen Deprivation Therapy for Prostate Cancer Improves Survival for Synchronous or Metachronous Non-Small Cell Lung Cancer: A SEER-Medicare Database Analysis

Bassel Nazha et al. Cancers (Basel). .

Abstract

Introduction: The crosstalk between receptor kinase signaling, such as EGFR and androgen receptor signaling, suggests a potential interaction between androgen deprivation therapy (ADT) and lung cancer outcome. Methods: We employed the SEER−Medicare data of lung cancer patients diagnosed between 1988 and 2005 to test for an association between ADT for prostate cancer and lung cancer outcome. We employed the Kaplan−Meier method and Cox proportional hazard with log-rank test model to assess any significant impact of ADT on survival. Results: We included data from 367,750 lung cancer patients; 17.4%, 2.9%, 33.6% and 46.1% with stages I, II, III and IV, respectively; 84.5% were >65 years; 57.2% males; 84.2% Caucasians and 9.3% Blacks. There were 11,061 patients (3%) with an initial prostate cancer diagnosis followed by lung cancer (P-L group); 3017 (0.8%) with an initial diagnosis of lung cancer and subsequent prostate cancer diagnosis (L-P group); the remainder had only lung cancer (L group). Stage I lung cancer was most common in the L-P group compared to the L and P-L groups—54% vs. 17.13% vs. 17.92%, p < 0.0001 for L-P, L and P-L, respectively. The median OS for lung cancer diagnosis was 93 months versus 10 and 9 months, respectively, for the L-P, L and P-L subgroups. ADT was associated with improved survival on multivariate analysis, especially in Caucasian patients (HR of death: 0.86; 95% CI: 0.76−0.97; p = 0.012). Conclusion: ADT was associated with improved outcome for NSCLC, in line with the hypothesis of a role for the androgen receptor in lung cancer. Our findings support a systematic evaluation of the potential benefit of ADT as a therapy for lung cancer.

Keywords: SEER; androgen deprivation therapy; hormonal therapy; lung cancer; prostate cancer.

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Conflict of interest statement

B.N. reports a paid advisory board role for Exelixis and was a paid participant in a case discussion for IntrinsiQ Specialty Solutions—AmerisourceBergen. T.K.O. reports a paid advisory board role for BMS, AstraZeneca and Merck, and a paid consultancy (data monitoring board) for Roche/Genentech and EMD Serono. All other authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Kaplan–Meier plot for overall survival (OS) comparing the three subgroups, L, P-L and L-P.
Figure 2
Figure 2
Kaplan–Meier plot for overall survival (OS) in P-L subgroup comparing patients treated with and without ADT.
See this image and copyright information in PMC

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