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At this point, it wouldn’t be surprising to hear that GLP-1 drugs can do your taxes. They can seemingly do everything else: The Ozempics and Zepbounds of the world treat diabetes and obesity, help with sleep apnea, reduce the risk of heart attack and stroke, and potentially even play a role in addiction treatment. Now, a new study published in the Journal of Clinical Oncology suggests that they may slow cancer progression.
You might wonder how on Earth a drug meant for diabetes and weight management could do this. But Mark Orland, MD, an internal medicine physician at the Cleveland Clinic and lead author of the study, says that researchers have long been curious about the potential of GLP-1s for other health issues. “There’s kind of this pleiotropic effect of the medication,” he says, meaning it has multiple additional benefits on top of its intended use. In the case of GLP-1s, that includes helping with kidney disease and cardiovascular issues, as well as potential inflammation-reducing effects. “It makes us start to think, ‘What else could this drug be used for?”
What Did the Study Find?
Researchers at the Cleveland Clinic combed through a massive global health database of around 150 million people to find 10,255 patients who had a confirmed diagnosis of early-stage cancer (stages one to three) of seven different cancer types: breast, prostate, colorectal, renal cell, pancreatic, non-small cell lung, and hepatocellular carcinoma (a type of liver cancer). They wanted to compare patients who started a GLP-1 drug versus those who started a different type of anti-diabetic drug, called DPP-4s or gliptins, says Dr. Orland, to see if there were differences in how many of them progressed to stage 4 cancer.
After controlling for variables like obesity and A1C levels (to make sure those factors weren’t behind any results), researchers analyzed the data and found something pretty remarkable: GLP-1 users were 38 to 50 percent less likely to have their cancers progress to stage four (metastatic) in four out of the seven cancer types. For example, 10 percent of breast cancer patients on GLP-1s ended up developing metastatic cancer, compared to 20 percent of those on gliptins. Among colorectal cancer patients, 13 percent of GLP-1 users progressed to stage 4 cancer versus 22 percent of the gliptins group. GLP-1 users with lung and liver cancer were also significantly less likely to progress to stage four.
What surprised Dr. Orland most was that there was such a marked slowdown in growth among several extremely different types of cancer. We don’t have the data to know exactly why, but Dr. Orland cites multiple theories. “Each of these cancers might have their own unique pathway that GLP-1s act on,” he says. “Another possibility is that there is a kind of aligning pathway between all of those cancers [that GLP-1s influence], like a pro-tumorigenic [supporting the growth of tumors] pathway that crosses these four cancer types.” The anti-inflammatory effects of GLP-1s may also play a role, but aren’t solely responsible for these results. “Because then an anti-inflammatory drug like metformin or even ibuprofen would work as well [at slowing cancer progression],” he says, and they do not.
What Does This Mean for Cancer Patients Today?
This is an emerging field of study, but Dr. Orland believes the immediate takeaway is that GLP-1s will likely not worsen an existing case of cancer. That’s great news for the millions of people with diabetes, who inherently have a higher risk of developing certain cancers (like breast, colorectal, and pancreatic). If the reverse is true, and “a cancer patient needs a diabetes drug, and a GLP-1 is not otherwise contraindicated…we can say fairly definitively, ‘Hey, you’re not going to have more stage four progression because of this drug,’” he explains.
Whether these drugs could actually treat cancer, or prevent it altogether, needs much more study. Rather than just relying on retrospective patient data, Dr. Orland says, “it's really important you start prospective trials,” meaning you recruit cancer patients who start a GLP-1 and then track them for several years. He also says there needs to be more research exploring the mechanisms of how GLP-1s themselves work in the body. That way, we’d have a clearer sense of how else these drugs could be used.
Maybe in five or 10 years, a GLP-1 might be a standard part of cancer treatment alongside chemotherapy and radiation. Until then, we’ll be keeping an eye on the research—and hoping for even more good news.
