The emerging implications of GLP-1 receptor agonists in radiation therapy

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for patients with diabetes, obesity, and cardiometabolic disease. This trend has led to a growing number of patients taking these medications while receiving cancer treatment, including radiation therapy (RT). The delivery of RT relies on weight stability and anatomic reproducibility, which may be influenced by GLP-1 RA-related weight loss, delayed gastric emptying, and associated side effects. While current research has largely focused on perioperative outcomes and metabolic effects, we discuss the impact that GLP-1 RA use may have on radiation treatment planning, the need for adaptive radiation techniques, and RT related toxicity. We propose strategies to support safe RT and highlight the need for consensus recommendations regarding the use of GLP-1 RAs in patients requiring cancer treatment.