Reply to Yu Wei, Yao Zhu, and Dingwei Ye's Letter to the Editor re: Fabio Turco, Andrew Armstrong, Gerhardt Attard, et al. What Experts Think About Prostate Cancer Management During the COVID-19 Pandemic: Report from the Advanced Prostate Cancer Consensus Conference 2021. Eur Urol. 2022;82:6-11.

We thank Zhu et al for their interest in our recent article [1]. At the Advanced Prostate Cancer Consensus Conference 2021 (APCCC 2021) the panel voted on questions regarding prostate cancer management during the COVID-19 pandemic but there was no specific question about patients enrolled in clinical trials.

The APCCC panel reached a strong consensus (agreement of 97% of panelists) that COVID-19 vaccination should be recommended for all patients with advanced prostate cancer. Accordingly, we agree with the suggestion that COVID-19 vaccination should also be recommended to the subset of patients with advanced prostate cancer who enrol in clinical trials. But we strongly believe that the recommendation for vaccination should not be limited to this subgroup of patients.

In the ARASENS trial, the risk of death was 32.5% lower in the darolutamide group than in the placebo group (hazard ratio 0.68,95% confidence interval 0.57–0.80; p < 0.001) [2]. The prespecified primary analysis for overall survival was carried out after a total of 533 deaths were observed. The six deaths attributed to COVID-19 represent less than 1.1% of all deaths and had no meaningful impact on the study results.

Conflicts of interest

Fabio Turco and Matthew Smith have nothing to disclose. Aurelius Omlin has received institutioanl advisory fees from AstraZeneca, Astellas, Bayer, Janssen, Molecular Partners, MSD, Pfizer, Roche, and Sanofi Aventis; institutional research support from TEVA and Janssen; travel support from Astellas, Bayer, Janssen, and Sanofi Aventis; and institutional speaker bureau fees from Bayer, Astellas, and Janssen. Silke Gillessen has received personal honoraria for participation in advisory boards from Sanofi, Orion, Roche, Amgen, and MSD, and other honoraria from Televisione Svizzera Italiana; has been an invited speaker for ESMO, the Swiss Group for Clinical Cancer Research (SAKK), the Swiss Academy of Multidisciplinary Oncology (SAMO), the Orikata Academy Research Group, and the China Anti-Cancer Association Genitourinary Oncology Committee (CACA-GU); participates in a speaker bureau for Janssen Cilag; has received a travel grant from ProteoMEdiX; has received institutional honoraria for participation in advisory boards from Bayer, Janssen Cilag, Roche, AAA International, Amgen, Menarini Silicon Biosystems, Astellas Pharma, Tolero Pharmaceutcials, MSD, Pfizer, Telixpharma, BMS, and Orion; and holds patent royalties and other intellectual property for a research method for a biomarker (WO2009138392).