GLP-1RAs Reduce Risk of Some Obesity-Related Cancers in Patients with T2D: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in JAMA Network Open that compared the incident risk of 13 obesity-associated cancers (OACs) in patients with type 2 diabetes (T2D) who were prescribed glucagon-like peptide receptor agonists (GLP-1RAs) vs insulins or metformin.

The study

Researchers conducted a retrospective cohort study of deidentified electronic health records on the TriNetX platform. A total of 1 651 452 participants (mean age, 59.8 years; 50.1% men) with T2D and no prior diagnosis of OACs prescribed GLP-1RAs, insulin, or metformin between March 2005 and November 2018 were enrolled in the study. The occurrence of first-time diagnoses for each of the 13 types of OACs was examined over a 15-year follow-up period after initial exposure. All models were adjusted for confounders at baseline.

Among the study population, 60.6% were White, 17% were Black, 4% were Asian, 0.4% were American Indian or Alaska Native, and 0.8% were Native Hawaiian or other Pacific Islander.

The findings

Compared with insulin, those who received GLP-1RA treatment had significantly reduced risks of:

• Gallbladder cancer (HR 0.35, 95% 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)

Investigators reported that use of GLP-1RAs was associated with a lower risk of stomach cancer compared with insulin use, although it did not reach statistical significance (HR 0.73, 95% CI 0.51-1.03).

Compared with metformin, GLP-1RA therapy was not associated with a decreased risk of any cancers but wasassociated with an increased risk of kidney cancer (HR 1.54, 95% CI 1.27-1.87).

Authors' comment

"These findings provide preliminary evidence of the potential benefit of GLP-1RAs for cancer prevention in high-risk populations and support further preclinical and clinical studies for the prevention of certain OACs."

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