In a retrospective cohort study reported in JAMA Network Open, Tatum et al found that use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) was associated with reduced risk of all-cause mortality in patients with breast cancer and obesity or type 2 diabetes (T2D).
Study Details
The study used TriNetX US Collaborative Network data from women with breast cancer from 68 health-care organizations who received a breast cancer diagnosis between April 2006 and April 2023. Propensity score matching was used to balance baseline characteristics. GLP-1 RA use was defined as at least two prescriptions during the 6 months before and any time after the index breast cancer diagnosis. The primary outcome measure was all-cause mortality over a 10-year follow-up.
Key Findings
The study included 841,831 eligible patients (mean age = 69.1 years).
After exclusions and 1:1 propensity score matching, three cohorts were identified: 1,610 patients for GLP-1 RA use vs nonuse in patients with obesity; 2,323 patients for GLP-1 RA use vs insulin or metformin use for T2D; and 4,052 patients for GLP-1 RA use vs sodium-glucose cotransporter 2 (SGLT2) inhibitor use for T2D.
Among patients with obesity, GLP-1 RA use vs nonuse was associated with a significantly lower risk of 10-year all-cause mortality (hazard ratio [HR] = 0.35, 95% confidence interval [CI] = 0.21–0.58, P < .001) and risk of recurrence or death (HR = 0.44, 95% CI = 0.30–0.64, P < .001).
Among patients with T2D, GLP-1 RA use vs use of insulin or metformin was associated with a significantly lower risk of 10-year all-cause mortality (HR = 0.09, 95% CI = 0.06–0.15, P < .001) and risk of recurrence or death (HR = 0.33, 95% CI = 0.21–0.50, P < .001).
Among patients with T2D, GLP-1 RA use vs use of SGLT2 inhibitors was not associated with significantly lower risk of 10-year all-cause mortality (HR = 0.97, 95% CI = 0.82–1.14, P = .72) or risk of recurrence or death (HR = 0.91, 95% CI = 0.71–1.18, P = .46).
The investigators concluded: “In this cohort study of patients with [breast cancer], findings suggested a potential association between GLP-1 RA use and improved outcomes among patients with [breast cancer] who have obesity and related metabolic conditions. These findings support further evaluation of GLP-1 RA therapy in randomized clinical trials.”
Bernard F. Fuemmeler, PhD, MPH, of Massey Comprehensive Cancer Center, Richmond, Virginia, is the corresponding author for the JAMA Network Open article.
DISCLOSURE: The study was supported by the National Cancer Institute. For full disclosures of the study authors, visit jamanetwork.com.
