GLP-1 Drugs and Cancer Progression

New research suggests a potential connection between GLP-1 medications and a decreased risk of cancer progression. This information will be shared at the upcoming annual meeting of the American Society of Clinical Oncology.

These diabetes and weight loss drugs have had an expanding list of health benefits, including recent approvals aimed at reducing heart disease risk with Wegovy, and preventing worsening kidney disease with Ozempic. Additionally, Zepbound is used to treat obstructive sleep apnea. Researchers are still exploring other possible benefits.

The latest findings are based on data not yet published in a peer-reviewed journal but contribute to growing evidence that GLP-1s might have anti-cancer properties.

Dr. Mark Orland from the Cleveland Clinic led the study, examining records from the TriNetX Global Health Research Network. They identified over 10,000 patients diagnosed with various cancers, including breast, colorectal, kidney, liver, lung, pancreatic, and prostate cancers, all at stages 1, 2, or 3, who began taking GLP-1 drugs post-diagnosis.

The exact reason these patients were prescribed the medication—whether for diabetes or obesity—remains uncertain. To create a control group, researchers paired GLP-1 users with patients sharing the same type and stage of cancer, as well as similar health issues like obesity or smoking. The control group started a different Type 2 diabetes medication known as a DPP-4 inhibitor.

Findings showed that patients using GLP-1 medications were less likely to experience tumor metastasis across all cancer types studied, except for kidney cancer. However, significant reductions were noted in four cancers—non-small cell lung cancer, breast cancer, colorectal cancer, and liver cancer—where fewer patients experienced progression.

Notably, lung cancer patients on GLP-1s experienced a 50% lower likelihood of progressing to stage 4 compared to those on DPP-4 inhibitors. For breast cancer, the reduction was about 43%. Yet, it’s worth emphasizing that this study was observational, so it can’t definitively establish a causal relationship. More rigorous clinical trials are needed to confirm if GLP-1s can actually slow cancer growth.

Orland expressed that he believed the observed benefits likely stemmed from the drug itself, rather than improved management of diabetes or obesity, both of which can influence cancer outcomes.

Dr. William Troy Donahoo, an expert in endocrinology at the University of Florida who didn’t partake in this study, shared a similar viewpoint, suggesting the effects could be attributed to GLP-1 itself. He contributed to a previous study linking GLP-1 use to a decreased cancer risk.

The new research also hinted at a possible explanation: patients using GLP-1 receptor agonists with a higher number of GLP-1 receptors in their tumors were less prone to metastasis.

Future investigations should delve deeper into how the number of GLP-1 receptors on tumors may influence their responsiveness to GLP-1 treatments, as suggested by Dr. Kelvin Lee from Indiana University’s cancer center.

“Targeting a receptor on tumor cells might disrupt their communication, which could hinder their ability to spread,” Lee explained.

There’s also a chance that disrupting GLP-1 receptors might interfere with glycolysis, the process where cells convert glucose into energy. This could potentially starve tumors of the energy they need to grow.

Regardless of the underlying mechanism, it seems that these drugs may have a dual impact, affecting both the tumor cells directly and their surrounding environment. “Cancers exist in a complex ecosystem within the body,” Lee noted.

Additionally, GLP-1 medications might enhance the immune system’s ability to fight cancer while simultaneously reducing inflammation, which can be beneficial for tumors.

Future studies are essential to verify whether GLP-1s truly have anti-cancer effects and to further investigate why they may limit cancer spread.

“Every type of cancer presents its own unique challenges,” Donahoo remarked.

Lee cautioned that even with potential benefits confirmed, GLP-1 drugs are unlikely to become first-line treatments for any cancer type.

Orland emphasized that the key takeaway is the safety of these drugs for patients with diabetes or weight issues who are receiving cancer treatments, although it is premature to recommend them specifically for cancer therapy.