Can GLP-1 Receptor Agonists Curb Cancer? Study Links Drugs to Reduced Risk in Obesity-Related Cases

Glucagon-like peptide-1 (GLP-1) receptor agonists, which have soared in popularity as they helped people lose weight, may also help prevent certain obesity-related cancers in patients with type 2 diabetes (T2D), a new study has found.

Results released ahead of the 2025 Annual Meeting of the American Society of Clinical Oncology (ASCO) show the drug class is associated with a modest drop in the risk of developing 14 cancers tied to obesity. Patients who took GLP-1 receptor agonists experienced a 7% lower risk of developing an obesity-related cancer and an 8% lower risk of death from any cause, compared with patients who took a different diabetes drug, a dipeptidyl-peptidase-4 (DPP-4) inhibitor. The DPP-4 class does not cause weight loss or weight gain.

Investigators led by Lucas A. Mavromatis, ScB, a medical student at the NYU Grossman School of Medicine in New York, New York, evaluated data from 170,030 adults served by 43 health systems in the United States. All patients in the study had a diagnosis of T2D and a body mass index (BMI) of at least 30 kg/m², which is the cutoff for patients to be considered obese. The study captured data from 2013 to 2023; over that decade, the obesity rate among US adults rose from 37.5% to 45.6%.

“Obesity is a rising epidemic in the United States and globally,” Mavromatis said. “Obesity is a proven driver of 14 major cancers, including various cancers of the [gastrointestinal] tract, such as colorectal and pancreatic cancers, as well as many cancers of female sex organs such as postmenopausal breast cancer and some other cancers.”

Cancers linked to obesity include those of the esophagus, colon, rectum, stomach, liver, gallbladder, pancreas, kidney, postmenopausal breast, ovary, endometrium, and thyroid, as well as multiple myeloma and meningiomas.

"This trial raises an intriguing hypothesis: that the increasingly popular GLP-1 medications used to treat diabetes and obesity might offer some benefit in reducing the risk of developing cancer,” Robin Zon, MD, FACP, FASCO, ASCO president, said in a statement.

Rise of GLP-1s for Weight Loss

GLP-1 receptor agonists were first approved to treat T2D. The first wave of drugs produced some weight loss: these included exenatide (Byetta), which was approved in 2005, and liraglutide (Victoza), approved in 2010. But the next wave of GLP-1s, including semagulatide, proved more powerful and effective in helping patients lose weight. Studies showed that semaglutide allowed patients to shed an average of 10% to 15% of their weight, with some patients losing well over 20 pounds. GLP-1 therapies have been shown to produce a range of cardiovascular (CV) benefits, including cutting the risk of CV events.

Semaglutide is sold as Ozempic for its original indication in T2D and as Wegovy for weight loss. Global sales topped $40 billion in 2024, according to data released by Novo Nordisk. GLP-1s experienced shortages at one point, and prices rose. Cost concerns prompted many employers to limit coverage to patients taking the drugs for diabetes or CV indications; they will no longer pay if the drugs are used solely for weight loss.

Mavromatis said most patients in the study took liraglutide, although some took the more powerful semaglutide.

Links to Reduced Cancer Risk

Although GLP-1 receptor agonists represented a breakthrough in treating diabetes and obesity, Mavromatis said, “the long term risk of these weight management therapies on obesity related cancer incidence is unknown.”

“While there's biologically plausible links between GLP-1 use and reduced obesity related cancer incidents, it has yet to be shown in any human studies,” he continued. Patients taking the drugs sometimes ask about long-term risks, so these new data address those concerns, in addition to the surprise results involving cancer.

The observational study to be presented during ASCO used propensity score matching to ensure the 2 groups had similar characteristics, thereby creating more comparable groups in the absence of a randomized controlled trial. Both groups had 85,015 patients.

Results showed the following:

• Patients were evenly divided between those starting with a GLP-1 receptor agonist and those who took a DPP-4 inhibitor. Their average age was 56.8 years; about half were women. More than 70% were White, and more than 14% were Black. The average BMI was 38.5 kg/m².
• After a mean follow-up of 3.9 years, there were 2501 newly diagnosed cases of obesity-related cancer in the GLP-1 group. The DDP-4 inhibitor group had 2671 cases of obesity-related cancer. The risk of developing cancer fell 7% (HR, 0.93; 95% CI, 0.88-0.98; P = .005) in the former group while the risk of all-cause mortality fell 8% (HR, 0.92; CI, 0.87-0.92; P = .001).
• Results varied across different cancer types. Assessments of cancer subtypes showed protective associations between the GLP-1 class and colon and rectal cancers.

A KFF survey found that about 1 in 8 US adults, or 12% of the population, have taken a GLP-1 therapy, in part to address the nation’s obesity crisis. The survey also found that those taking the drugs often had trouble affording them.

Rising obesity rates have been cited as a possible cause of the spike in cancer among younger adults, especially colorectal, kidney, and pancreatic cancers.

Mavromatis said while a randomized trial to prove a link between GLP-1s and cancer prevention might be “ideal,” the size and duration that would be needed to produce meaningful evidence would be challenging.

But ASCO Chief Medical Officer Julie R. Gralow, MD, said that if 12% of the population uses these drugs, “it’s certainly worth studying in a way that we can get solid evidence to support whether or not there is a role to be using these drugs, especially in an overweight or obese population, for many health reasons—not just cancer reasons.”

Zon said in addition to exploring the possible causative effect, it would be worth studying patients who do not have diabetes.

Funding for this study came from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.

Reference

Mavromatis LA, Surapanei A, Mehta S, et al.Glucagon-like peptide-1 receptor agonists and incidence of obesity-related cancer in adults with diabetes: a target-trial emulation study. Presented at: ASCO Annual Meeting; May 31-June 3, 2025; Chicago, IL. Abstract 10507.