Study finds GLP-1 drugs may cut obesity-related cancers

Potentially adding to a lengthening list of positive health benefits of GLP-1 agonist drugs, a new study has suggested they may also reduce the risk of a bevy of cancers associated with being very overweight.

The retrospective analysis published in JAMA Network Open, which looked at electronic health records from people in the US with type 2 diabetes, found that the use of GLP-1 agonists was associated with a reduced risk of 10 out of 13 obesity-associated cancers (OACs).

The cohort from the TriNetX platform of de-identified EHRs included 1.6 million type 2 diabetics who had been prescribed either GLP-1 drugs – such as Novo Nordisk’s Ozempic (semaglutide) or Eli Lilly’s Trulicity (dulaglutide) – or insulin as a control.

The 13 OACs covered by the study were oesophageal, breast, colorectal, endometrial, gallbladder, stomach, kidney, ovarian, pancreatic, and thyroid cancers, as well as liver cancer (hepatocellular carcinoma), meningioma, and multiple myeloma.

A significant risk reduction was seen in 10 of the cancers, excluding stomach cancer – which showed a trend towards lower risk – as well as thyroid cancer or postmenopausal breast cancer over 15 years of follow-up.

The most striking reductions were seen with gallbladder cancer, meningioma, and pancreatic cancer, down by around 60%, with reductions of 24% to 65% across the entire group.

The study also included a cohort of type 2 diabetes patients treated with metformin, a common oral antidiabetic drug (OAD). Looking at that group, GLP-1 therapy was not associated with a lower risk of colorectal cancer, gallbladder cancer, and meningioma compared to metformin – which was not statistically significant – but was associated with an increased risk of kidney cancer.

The authors of the study – from Case Western Reserve University School of Medicine and the MetroHealth System in Cleveland, Ohio – said the findings provide “preliminary evidence of the potential benefit of [GLP-1 agonists] for cancer prevention in high-risk populations and support further preclinical and clinical studies for the prevention of certain OACs.”

While more research is needed, the prospect of reducing the risk of some very common cancers adds the weight of evidence behind the GLP-1 agonist class, members of which have now been approved for diabetes, obesity, and cardiovascular risk reduction in people who are overweight with underlying risk factors.

In addition, clinical trials have pointed to benefits in other indications, including chronic kidney disease, metabolic dysfunction-associated steatohepatitis (MASH), Parkinson’s disease, Alzheimer’s, and even addiction.

The wide range of potential uses has, however, led to concerns that the class could put a strain on healthcare services around the world unless their list prices – currently upwards of $12,000 per year in the US, for example – are reduced.

A report issued by the office of independent US Senator Bernie Sanders in May claimed that the prices currently being charged for the therapies could end up bankrupting US healthcare systems and drive the US prescription medicines bill to around $1 trillion a year.

Photo by National Cancer Institute on Unsplash