Originally approved for the treatment of diabetes before demonstrating efficacy in weight management, GLP-1 medications continue to interest clinical researchers for additional uses, now including cancer prevention.
The American Cancer Society reports that while GLP-1 drugs are not approved for cancer prevention, GLP-1s could help reduce cancer risks for multiple reasons. First, excess body weight is a risk factor for 13 types of cancer, and managing weight can help reduce cancer risks, but GLP-1s may also make it harder for cancer cells to grow in the body by starving the cells, reducing inflammation, and helping immune cells, which help better signal early cancer detection.
Several studies in the last year have found links to GLP-1 medications and a lower likelihood of developing certain cancers, and if evolving clinical research strengthens these links, the already high utilization of GLP-1 medications – which is already seeping into workers’ comp programs – could continue to grow, requiring even further attention in regards to pharmacy management.
A recent study from the American Society of Clinical Oncology reviewed the health records of 12,112 patients who had one of seven types of obesity-related cancers. The study reviewed what impact GLP-1 drugs had on cancer progression when compared to DPP-4 inhibitors (also known as gliptins), a class of drugs used for the treatment of diabetes.
Half the patients in the study started on GLP-1 medications after cancer diagnosis, while half started on gliptins, and the study compared the number of people in both groups who progressed to stage IV cancer.
For four of the seven cancer types – lung, breast, colorectal, and liver – patients who took GLP-1 drugs were 38% to 50% less likely to develop stage IV cancer than people who took gliptins. In those four types of cancers, metastasis occurred in a lower percentage of the GLP-1 group than the gliptin group:
- Lung: 10% (GLP-1) vs. 22% (gliptin)
- Breast: 10% vs. 20%
- Colorectal: 13% vs. 22%
- Liver: 19% vs. 28%
For three other cancer types – prostate, pancreatic, and kidney – the GLP-1 group had fewer instances of metastasis than the gliptin group, but the differences were not statistically significant.
While these results are noteworthy, the authors of the study stress the need for further research into the mechanics of GLP-1s. However, this is not the first study to note GLP-1 drugs potential to slow cancer progression.
A different study from JAMA Oncology compared health records across 86,632 adults, half who took GLP-1s and half who didn’t. The primary outcomes were the incidence rates of 14 different types of cancer, 13 of which were obesity-associated cancers. The study found that GLP-1 users had a significantly lower overall cancer risk.
Additionally, a study from The Lancet reviewed the medical records of 6,356 patients with obesity and diabetes who had no history of obesity-related cancer (ORC). The study population was made up of individuals who either underwent weight loss surgery or began taking GLP-1 medications, keeping track of changes from 2010-2023.
The study found that both groups had similar incidence rates of ORCs, but this remained true even when those who received surgery experienced greater weight loss than the GLP-1 group, indicating additional pathways beyond weight loss in which GLP-1RAs might contribute to the decreased risk for ORC, such as reducing inflammation.
Time will tell if GLP-1 drugs show true promise in helping to slow cancer progression or reduce cancer likelihood, most experts agree that more research is necessary and that GLP-1 drugs still come with notable side effects and precautions that must be weighed holistically on a case-by-case basis for individual patients.
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