A real-world analysis of more than 10,000 patients with cancer found that GLP-1 receptor agonists (RAs) were associated with dramatically reduced metastatic progression across four different malignancies and independently improved overall survival in seven tumour types
The study is one of the largest to date to explore the intersection of GLP-1 RAs and oncology, and was presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, US.
“These agents were developed primarily for type 2 diabetes, but their cardioprotective, weight-reducing, and anti-inflammatory properties demand careful evaluation in patients with concurrent malignancy,” said lead study author Dr Mark Orland of Cleveland Clinic, US.
“Our study addresses this [hypothesis] directly, finding that GLP-1 RA exposure, compared to all other antidiabetic drug classes, was associated with meaningful mitigation of cancer progression across seven solid tumour types. That this signal emerged from a real-world population adds both relevance and urgency to the findings.”
Researchers used TriNetX, a global health research network with more than 145 million patient records, to identify individuals with stage I-III cancer who started GLP-1 RA therapy after being diagnosed. The cohort comprised 10,225 patients who were propensity matched on a 1:1 basis to individuals receiving dipeptidyl peptidase-4 inhibitors for type 2 diabetes across seven cancer types: Breast adenocarcinoma, prostate adenocarcinoma, non-small cell lung cancer (NSCLC), colorectal cancer (CRC), hepatocellular carcinoma (HCC), renal cell carcinoma, and pancreatic adenocarcinoma.
Researchers found that GLP-1 RA exposure was associated with a significant reduction in progression to stage IV disease in four cancer types: NSCLC, breast cancer, CRC, and HCC. For example, the cumulative incidence of stage IV progression was 10.0 per cent for patients with NSCLC on GLP-1 RAs compared with 22.3 per cent for individuals on dipeptidyl peptidase-4 inhibitors. Similarly, metastatic progression occurred in 10.2 per cent versus 20.1 per cent in breast cancer, and 13.4 per cent versus 22.2 per cent in CRC, respectively.
Dr Orland also noted that directional protection was observed in pancreatic cancers, even though statistical significance was not achieved. In addition, there were no significant increases in adverse events for patients receiving GLP-1 RAs.
“These results deserve cautious optimism. For patients managing both diabetes and cancer, the possibility that their anti-diabetic medication may also be working in their favour is an encouraging finding. That said, these are observational data, and observational data have limits,” Dr Orland explained.
In addition, he noted that these findings must be assessed in randomised controlled trials in which GLP-1 RA use is assigned rather than observed.
“In parallel, understanding the biological mechanism is essential: Whether the protective signal operates through immunomodulation, direct GLP-1 receptor signalling on tumour or stromal cells, reduction in systemic inflammation, or metabolic reprogramming remains an open and important question that we are actively pursuing,” Dr Orland concluded.
Results of a separate retrospective study involving almost 100,000 women presented at the 2026 ASCO Annual Meeting also show a correlation between GLP-1 RA use and reduced breast cancer incidence.
The retrospective, time-dependent (1 January 2022 to 30 June 2025) cohort study managed by the American College of Radiology identified women aged 45 to 80 years with a BMI greater than 25 who underwent breast imaging at the University of Pennsylvania and its affiliates. Among 94,827 eligible women, 2,314 (2.4%) were diagnosed with breast cancer during the study period. Of the total, 15,107 (15.9%) had GLP-1 RA exposure. Among those exposed to GLP-1 RAs, 249 (1.65%) developed breast cancers. Among women without exposure to GLP-1 RAs, there were 2065 (2.6%) women diagnosed with breast cancer.
The results show that those who took GLP-1 RA medications were up to 35 per cent less likely to develop breast cancer than those who did not take GLP-1 RAs after accounting for age, race, ethnicity, BMI, breast density, and type 2 diabetes status.
These findings support the need for prospective trials investigating incretin medications for breast cancer prevention, said study lead Prof Elizabeth McDonald, Professor of Radiology, University of Pennsylvania Perelman School of Medicine, US, and chair of ACR’s Breast Imaging Research Committee.
“By identifying tools to help reduce the number of women who develop cancer, and combining those with ever-improving tools, techniques and processes to diagnose and treat cancer, we can greatly reduce the number of breast cancer deaths, the number of women and families impacted by this terrible disease, and possibly reduce the financial costs to the healthcare system and patients,” said ACR Chief Research Officer and a senior author of the study Dr Etta D Pisano.
“We need a large prospective study to determine whether use of these GLP-1 drugs can help many women avoid developing the disease at all. Given the evidence to date, that is a next logical and potentially lifesaving step.”
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