Effect of GLP-1 Receptor Agonists on Patients with Thyroid Carcinomas Undergoing Active Surveillance
Armando Patrizio1, Samantha K Newman1, R Michael Tuttle1
1Endocrinology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA.
Context:
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as effective therapies for diabetes mellitus and obesity. Their effect on nonmedullary thyroid malignancies remains unclear.
Objective:
To evaluate the impact of GLP-1RA exposure on tumor kinetics of patients with low-risk papillary thyroid carcinoma undergoing active surveillance (AS).
Design:
Retrospective observational cohort study of 18 patients with 19 papillary thyroid carcinomas (≤1.5 cm) exposed to GLP-1RA matched 1:2 by body mass index and tumor size to 37 patients with 38 carcinomas never exposed to GLP-1RA and undergoing AS at a single tertiary center for a median of 5.5 years.
Main Outcome:
Tumor growth/shrinkage was considered significant when any diameter changed by ≥3 mm and/or volume changed >72%. Tumor volume doubling time was calculated in a subset of patients off and on GLP-1RA therapy.
Results:
After a median GLP-1RA exposure of 25 months [interquartile range: 14-34] and a median follow-up of 5.5 years, 2/19 (10.5%) tumors exposed to GLP-1RA exhibited significant volume growth, 1 (5.3%) decreased, and 16 (84.2%) remained stable, whereas 1/38 (2.6%) carcinomas not exposed to GLP-1RA showed >72% volume increase, 2/38 (5.3%) decreased, and 35/38 (92.1%) remained stable, P = .53. GLP-1RA exposure did not alter tumor volume growth kinetics in either of the 2 tumors that increased over time.
Conclusion:
GLP-1RA therapy does not affect tumor growth kinetics in patients with low-risk papillary thyroid carcinoma on AS. Further studies with larger cohorts and extended follow-up are warranted to validate the safety of GLP-1RA use in patients with thyroid carcinomas undergoing active surveillance.
Insights
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) did not impact tumor growth in patients with low-risk papillary thyroid cancer on active surveillance. Further research is needed to confirm the safety of GLP-1RA use in thyroid cancer patients.
Area of Science:
- Endocrinology
- Oncology
- Metabolic Diseases
Background:
- Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are established treatments for diabetes and obesity.
- The impact of GLP-1RAs on nonmedullary thyroid malignancies is not well understood.
Purpose of the Study:
- To investigate the effect of GLP-1RA exposure on tumor kinetics in patients with low-risk papillary thyroid carcinoma under active surveillance.
Main Methods:
- A retrospective observational cohort study compared 18 patients with papillary thyroid carcinomas exposed to GLP-1RA with 37 control patients not exposed.
- Tumor kinetics were assessed over a median follow-up of 5.5 years, with significant growth defined by diameter change ≥3 mm or volume change >72%.
Main Results:
- No significant difference in tumor growth kinetics was observed between the GLP-1RA exposed group (10.5% significant growth) and the unexposed group (2.6% significant growth) (P = .53).
- GLP-1RA exposure did not alter tumor volume growth rates in the few tumors that did increase in size.
Conclusions:
- GLP-1RA therapy does not appear to affect tumor growth kinetics in patients with low-risk papillary thyroid carcinoma undergoing active surveillance.
- Larger studies with longer follow-up are necessary to confirm the safety of GLP-1RA use in patients with thyroid carcinomas on active surveillance.
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