New research presented at the European Congress on Obesity (ECO) in Malaga, Spain, reveals that first-generation glucagon-like peptide-1 receptor agonists (GLP-1s), such as liraglutide and exenatide, offer anti-cancer benefits beyond their role in weight loss. Published in eClinicalMedicine, the study suggests these medications can help prevent obesity-related cancers, potentially making them a valuable tool in long-term cancer prevention.
A Comparative Study on GLP-1s and Bariatric Surgery
The study, led by Dr. Yael Wolff Sagy from Clalit Health Services, Tel Aviv, Israel, compares the incidence of obesity-related cancers in patients treated with GLP-1 drugs and those who underwent bariatric surgery. Over an average follow-up period of eight years, the study found similar cancer rates between the two groups, despite the greater weight loss achieved through surgery.
“Accounting for the superior weight loss with surgery, our study shows that GLP-1 receptor agonists (GLP-1RAs) are 41% more effective than bariatric surgery at preventing obesity-related cancers,” Dr. Sagy explained. “This underscores that the benefits of GLP-1s extend beyond weight loss.”
Understanding the Role of GLP-1 Drugs
GLP-1 medications are primarily used to control type 2 diabetes and aid weight management. They mimic the hormone GLP-1, which lowers blood sugar levels and helps individuals feel fuller for longer. However, increasing evidence suggests that these medications may offer broader metabolic benefits, including reduced cancer risks.
Obesity and type 2 diabetes are both associated with an elevated risk of several types of cancer, including post-menopausal breast cancer, colorectal cancer, and pancreatic cancer. These conditions are classified as obesity-related cancers.
Study Design and Results
For the study, researchers analyzed the health records of 6,356 patients from Clalit Health Services, all of whom had obesity (BMI ≥35 kg/m²) and type 2 diabetes, but no prior cancer history. Participants received either first-generation GLP-1s (such as liraglutide, exenatide, or dulaglutide) or bariatric surgery between 2010 and 2018.
Over a median follow-up of 7.5 years, 298 participants were diagnosed with obesity-related cancer. The most common types of cancer were postmenopausal breast cancer (26%), colorectal cancer (16%), and uterine cancer (15%).
The incidence of cancer was nearly identical between the two groups, with 5.76 cases per 1,000 person-years in the bariatric surgery group and 5.64 cases per 1,000 person-years in the GLP-1 group. However, when accounting for the difference in weight loss, GLP-1s showed a 41% greater effectiveness in reducing the risk of obesity-related cancers compared to surgery.
The Protective Mechanisms of GLP-1s
The researchers speculate that the protective effects of GLP-1s against cancer may be due to several mechanisms, including the reduction of inflammation, a known contributor to cancer development.
“Our study is unique in its long-term follow-up, allowing us to assess the effects of GLP-1s and surgery over a significant period—crucial for understanding the impact on cancers that have long latency periods,” said Professor Dror Dicker, co-lead author and Chief of Internal Medicine at Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel.
He added that future research into newer, more potent GLP-1 medications, which show greater efficacy in weight loss, could further enhance the drugs’ cancer prevention benefits. However, researchers cautioned that more studies are needed to confirm that these medications do not increase the risk of non-obesity-related cancers.
A Promising Development for Obesity-Related Cancer Prevention
Despite the promising findings, the authors note that this study is observational, and more randomized trials and prospective studies are needed to confirm these results. Nevertheless, the research highlights the potential of GLP-1 drugs as a key player in reducing the global burden of obesity-related cancers.
With obesity-related cancer rates on the rise, especially in countries with high obesity prevalence, these findings offer hope for a new, cost-effective strategy to mitigate cancer risk and improve public health outcomes.
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