GLP-1s and cancer: What to know

As researchers study the efficacy of GLP-1s like Ozempic and Mounjaro in treating dementia and other health issues with an eye toward expanding their usage, oncologists are looking at a GLP-1 role in cancer care.

Several studies have shown the therapies — currently approved for Type 2 diabetes, weight loss, cardiovascular disease, kidney disease, liver disease and sleep apnea — may also diminish the risk of multiple cancers:

• Researchers analyzed EHRs from 86,632 individuals between 2014 and 2024, and compared cancer risks of 43,317 GLP-1 users to 43,315 nonusers. Those taking GLP-1s had a 17% lower risk of developing endometrial, ovarian and meningioma cancers, the study found. 

• Researchers in Israel found a similar overall incidence of obesity-related cancers between GLP-1 users and people who underwent bariatric surgery — about 5 to 6 cases per 1,000 person-years — even though surgery led to more weight loss. However, after adjusting for the amount of weight lost, GLP-1s were associated with a 41% relative risk reduction in obesity-related cancers, suggesting that the drugs have cancer-protective effects beyond weight loss alone. 

• Compared with Type 2 diabetes patients taking insulin, those who took the medications were less likely to develop 10 of 13 obesity-related cancers, one study found. 

• In another study of Type 2 diabetes patients, GLP-1 users saw a decreased risk of colorectal cancer than those who took insulin, metformin, SGLT2 inhibitors, sulfonylureas and thiazolidinediones. 

• Both bariatric surgery and GLP-1 use reduced the risk of obesity-related cancers in a retrospective analysis, according to data presented at the American Society of Clinical Oncologists meeting in Chicago in June. Post-surgery, the risk declined 22%; with GLP-1s, the risk fell 39%. 

The results are promising, but oncologists will need to see more research before they change their practices. For example, Sara Jo Grethlein, MD, executive director of the Swedish Cancer Institute in Seattle, has questions about the study on 13 obesity-related cancers.

“It’s not clear if the reduction in cancer risk is due to the drugs themselves or the weight loss they cause,” Dr. Grethlein told Becker’s. “Even though surgery leads to more weight loss than GLP-1 drugs, the drugs had a bigger reduction in cancer risk and all-cause mortality. This raises intriguing questions about how much of the benefit is due to weight loss versus something inherent to the drugs themselves.”

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