GLP-1s linked to reduced obesity-related cancer risk in diabetics

A study recently published in JAMA Network Open proposes that GLP-1 receptor agonists, drugs currently approved for managing diabetes and obesity, may also lower the risk of certain obesity-associated cancers (OACs). This finding expands on existing research, indicating that GLP-1 drugs, including Novo Nordisk's semaglutide – marketed as Ozempic for diabetes and Wegovy for obesity – might provide additional health benefits beyond blood sugar control and weight reduction. Previous studies have already hinted at potential uses in cardiovascular and kidney disease.

The JAMA authors noted, "Given their effectiveness in managing type 2 diabetes, obesity, and related conditions, we theorized that these agents might also reduce the risk of OACs."

The study analyzed electronic health records from 113 million patients in the US, covering the years 2005 to 2018. The retrospective cohort study focused on over 1.6 million patients with type 2 diabetes who had not been previously diagnosed with obesity-associated cancers. These patients were prescribed either GLP-1s, insulin, or metformin.

The research indicated that patients treated with GLP-1 drugs had a considerably lower likelihood of developing 10 out of 13 obesity-associated cancers compared to those treated with insulin. Specifically, the risk reductions were as follows: gallbladder cancer (65%), meningioma (63%), pancreatic cancer (59%), hepatocellular carcinoma (53%), ovarian cancer (48%), colorectal cancer (46%), multiple myeloma (41%), oesophageal cancer (40%), endometrial cancer (26%), and kidney cancer (24%). Although there was also a reduced risk for stomach cancer, this did not reach statistical significance. No significant risk reduction was observed for thyroid cancer or postmenopausal breast cancer.

Conversely, when comparing GLP-1 drugs to metformin, the study did not find a statistically significant decrease in cancer risk for most types. However, the use of GLP-1 drugs was linked to an increased risk of kidney cancer.

The study concludes that "The potential cancer-preventative effects of GLP-1 receptor agonists on OACs warrant further long-term research, as well as studies on newer, potentially more effective antidiabetic and weight loss agents, including those with multi-hormone agonist activities." An example given is Eli Lilly's tirzepatide (Mounjaro/Zepbound), which targets both GLP-1 and GIP hormones.

Additionally, the authors advocate for research to determine the preventive effects of these agents on non-obesity-associated cancers.

The implications of these findings suggest broader applications for GLP-1 receptor agonists, potentially offering a new avenue for cancer prevention in patients managing diabetes and obesity. However, further studies are essential to fully understand the long-term benefits and risks associated with these medications.