JAMA Netw Open

GLP-1 agonists linked to reduced risk of several obesity-associated cancers

July 9, 2024

Among patients with T2DM who were cancer free at baseline, use of GLP-1RAs vs. insulin was associated with a lower risk of ten of 13 OACs. The findings provide preliminary evidence of a potential benefit of GLP-1 RAs for cancer prevention in high-risk populations and support further studies for the prevention of certain OACs.

This retrospective cohort study was based on EHR data on 113 million U.S. patients. The study population included patients with T2DM who had no prior diagnosis of OACs and were prescribed GLP-1RAs, insulins, or metformin between March 2005 and November 2018. Incident (first-time) diagnosis of 13 OACs occurring during a 15-year follow-up after exposure was examined.

In the study population of 1,651,452 patients with T2DM (mean age, 59.8 years; 50.1% male), GLP-1RAs vs. insulin were associated with a significant risk reduction in 10 of 13 OACs, including:

• gallbladder cancer: hazard ratio [HR], 0.35; 95% confidence interval [CI], 0.15-0.83
• meningioma: HR, 0.37; 95% CI, 0.18-0.74
• pancreatic cancer: HR, 0.41; 95% CI, 0.33-0.50
• hepatocellular carcinoma: HR, 0.47; 95% CI, 0.36-0.61
• ovarian cancer: HR, 0.52; 95% CI, 0.03-0.74
• colorectal cancer: HR, 0.54; 95% CI, 0.46-0.64
• multiple myeloma: HR, 0.59; 95% CI, 0.44-0.77
• esophageal cancer: HR, 0.60; 95% CI, 0.42-0.86
• endometrial cancer: HR, 0.74; 95% CI, 0.60-0.91
• kidney cancer: HR, 0.76; 95% CI, 0.64-0.91

Although not statistically significant, the HR for stomach cancer was less than 1 among patients who took GLP-1RAs vs. insulin (HR, 0.73; 95% CI, 0.51-1.03). No reduced risk of postmenopausal breast cancer or thyroid cancer was seen with GLP-1RA use. Of those cancers that showed a decreased risk among patients taking GLP-1RAs vs. insulin, HRs for patients taking GLP-1RAs vs. metformin for colorectal and gallbladder cancer were less than 1, but the risk reduction wasn’t statistically significant. Compared with metformin, GLP-1RAs weren’t associated with a decreased risk of any cancers but were associated with increased risk of kidney cancer (HR, 1.54; 95% CI, 1.27-1.87).

Source:

Wang L, at al. (2024, July 5). JAMA Netw Open. Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes. https://pubmed.ncbi.nlm.nih.gov/38967919/