Incretin Mimetics in Cancer and Cardiovascular Disease: JACC: CardioOncology State-of-the-Art Review

Incretin mimetics (glucagon-like peptide-1 receptor agonists and dual glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide receptor agonists) are paradigm changing for managing obesity, diabetes, and cardiovascular risk. These phenotypes are also associated with elevated risk for numerous cancers. Limited research suggests that incretin mimetics may be associated with lower risk for developing several cancers. However, more translational and randomized clinical data are needed for confirmation. Patients with cancer were excluded from trials of incretin mimetics. Therefore, their effects on adipose tissue, muscle, cardiovascular risk factors, and outcomes in this population are unknown. Notwithstanding contraindications with a history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2, translational data also promote the hypothesis that incretin mimetics could slow the growth of other cancers. Further clinical data are needed to determine which patients undergoing cancer treatment might experience benefit or harm from the anthropometric and calorie reduction effects of incretin mimetics or display cardiometabolic benefit despite the competing risk for cancer death.