GLP-1 Receptor Agonists Show Promise for Patients with Cancer and Type 2 Diabetes: JAMA
A new study published in The Journal of Clinical Endocrinology and Metabolism show that patients with type 2 diabetes receiving treatment for active cancer may benefit from GLP-1 receptor agonists (GLP-1RAs).
The use of GLP-1 receptor agonists (GLP-1RA) for Type 2 Diabetes (T2D) has increased since FDA approval in 2017. GLP-1RAs are especially important for cancer patients because they improve glycemic control, and tumors greatly depend on glucose metabolism to proliferate.
Clinical data on GLP-1RAs is still scarce, despite the well-established survival benefits of metformin for T2D patients with cancer. GLP-1RAs may prevent tumor growth, reduce mortality in some cancers, and lessen cardiovascular events during immunotherapy, according to preclinical and early clinical data.
Nevertheless, no research has directly compared the glycemic control of GLP-1RA and metformin monotherapies.
Therefore, this first comprehensive analysis evaluating how continued or new GLP-1RA treatment affects survival in T2D patients diagnosed with solid and hematologic malignancies across varying levels of glycemic control.
Researchers found a total cohort of 3747 patients with type 2 diabetes who received GLP-1RAs within three months of beginning systemic therapy using TriNetX, a global database with over 120 million patients.
They also found 52,061 patients who received metformin during the same period as a control cohort. Further subanalyses classified patients according to their obesity, glycated hemoglobin A1c (HbA1c) range, and whether they were "newly started" on GLP-1 RA within three months of beginning cancer treatment.
In both the overall monotherapy setting (hazard ratio [HR]: 0.875; 95% CI, 0.778-0.985; P =.0268) and the new-start setting (HR: 0.786; 95% CI, 0.662-0.934; P =.0062) cohorts, patients on GLP-1RAs had significantly lower mortality rates.
Secondary analyzes stratified by body mass index and HbA1c did not reach statistical significance.
Overall, assessing the effectiveness of novel treatments is crucial given the importance of optimal glycemic control in patients with cancer and diabetes. Regardless of start time, we discovered that patients exposed to GLP-1RAs showed significantly lower mortality and all-case hospitalization when compared to standard-of-care metformin.
Furthermore, patients starting GLP-1RAs on metformin showed better survival than those starting insulin, indicating that GLP-1RAs could be a useful second-line treatment for active cancer.
Source:
Mahadevan, A., Vosooghi, A., Arora, J. S., Kumar, R. S., Singh, G., Tsai, K. K., & Quandt, Z. (2026). GLP-1 receptor agonists in patients with cancer are associated with reduced all-cause mortality and hospitalization. The Journal of Clinical Endocrinology and Metabolism, 111(6), 1604–1612. https://doi.org/10.1210/clinem/dgaf703
