GLP-1 RAs May Lower Cancer Risk Linked to Obesity in T2D Compared to Insulin

Patients with type 2 diabetes (T2D) may benefit from glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in terms of reduced cancer risks, according to research published on July 5 in JAMA Network Open. The study, led by Lindsey Wang from Case Western Reserve University School of Medicine in Cleveland, focused on the relationship between GLP-1 RAs and obesity-associated cancers (OACs).

The study involved a retrospective cohort analysis of 1,651,452 patients with T2D, all of whom had no prior diagnosis of OACs. The researchers compared the incidence rates of 13 different OACs in patients prescribed GLP-1 RAs to those who were prescribed insulins or metformin.

The findings demonstrated that GLP-1 RAs were linked to a significant risk reduction in 10 out of the 13 OACs when compared to insulin use. Specifically, the risk reductions were notable in gallbladder cancer, meningioma, pancreatic cancer, hepatocellular carcinoma, ovarian cancer, colorectal cancer, multiple myeloma, esophageal cancer, endometrial cancer, and kidney cancer. The hazard ratios for these cancers were 0.35, 0.37, 0.41, 0.47, 0.52, 0.54, 0.59, 0.60, 0.74, and 0.76, respectively. Although the hazard ratio for stomach cancer was less than 1, it lacked statistical significance. Additionally, the study found no risk reduction for postmenopausal breast cancer or thyroid cancer with the use of GLP-1 RAs.

When comparing GLP-1 RAs to metformin, the study did not find a significant risk reduction for any of the cancers. Interestingly, an increased risk for kidney cancer was observed in patients using GLP-1 RAs compared to those on metformin, with a hazard ratio of 1.54.

The researchers emphasize the need for further long-term studies to thoroughly investigate the potential cancer-preventative effects of GLP-1 RAs. They also suggest exploring newer and potentially more effective antidiabetic and weight loss medications, especially those with multihormone agonist activities, to understand their impact on cancer risks. The study's findings contribute to a growing body of evidence that GLP-1 RAs may play a role in reducing the risk of certain cancers in patients with T2D, although further research is essential to confirm these benefits and to assess the long-term implications.

In summary, this study highlights the potential advantages of GLP-1 RAs in lowering the risk of several obesity-associated cancers in patients with type 2 diabetes. However, it also underscores the importance of continued research to validate these findings and to explore additional therapeutic options for reducing cancer risks in this population.