Survival and Recurrence With GLP-1 Receptor Agonists in Breast Cancer

Area of Science:

• Oncology
• Endocrinology
• Pharmacology

Background:

• Patients with breast cancer (BC) and comorbid obesity or type 2 diabetes (T2D) exhibit poorer survival outcomes.
• Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are established treatments for obesity and T2D, but their impact on BC survival and recurrence is not well-defined.

Purpose of the Study:

• To investigate the association between GLP-1 RA utilization and 10-year all-cause mortality and recurrence-free survival (RFS) in breast cancer patients.
• To assess 5- and 10-year probabilities of all-cause mortality and RFS in relation to GLP-1 RA use.

Main Methods:

• A retrospective cohort study utilizing TriNetX US Collaborative Network data from women diagnosed with BC between April 2006 and April 2023.
• Propensity score matching was employed to balance patient characteristics between GLP-1 RA users and non-users.
• Outcomes included all-cause mortality and RFS, analyzed using Cox proportional hazards regression and Kaplan-Meier estimators over a 10-year follow-up.

Main Results:

• Among patients with obesity, GLP-1 RA use was associated with a significantly lower hazard of all-cause mortality (HR, 0.35) and RFS (HR, 0.44).
• In patients with T2D, GLP-1 RA use compared to insulin or metformin showed a substantially reduced hazard for all-cause mortality (HR, 0.09) and RFS (HR, 0.33).
• No significant differences were found between GLP-1 RA and SGLT2 inhibitor groups; subgroup and landmark analyses confirmed these findings.

Conclusions:

• Findings suggest a potential association between GLP-1 RA use and improved survival and recurrence outcomes in breast cancer patients with obesity and T2D.
• These results warrant further investigation through randomized clinical trials to validate the efficacy of GLP-1 RA therapy in this patient population.