Abstract 735: The associations between the use of GLP-1 receptor agonists, cancer recurrence and all-cause mortality among cancer survivors
Authors: Chen Po-Hua , Hibler Elizabeth A. 
Published: April 2023

Abstract
Introduction: GLP-1 receptor agonists (GLP-1RAs) have been shown to carry benefits not only in glucose control among diabetics, but also in reductions in obesity, systemic inflammation, and risk of cardiovascular disease. Evidence also suggests a significant overlap between all of these risk factors with cancer prognosis and survival. Thus, this study aims to investigate the associations between the use of GLP-1RAs, cancer recurrence, and all-cause mortality among cancer survivors.
Methods: We included a total of 67,591 cancer survivors treated at Northwestern Medicine (NM) on or after 01/01/2005. We also included a non-cancer population of NM patients 1:1 matched on age, gender, zip code, and history of diabetes or hypertension prior to cancer diagnosis (priority given to age, gender, and zip code). Finally, a subgroup analysis was performed among 34,907 cancer survivors for cancers with known associations to obesity (including thyroid, pancreatic, ovarian, liver, kidney, gynecological, colorectal, breast, gastric cancer, and multiple myeloma). Documented use of liraglutide, semaglutide, exenatide, or dulaglutide was considered as use of GLP-1RAs. Cox proportional hazards models were used to examine the associations between the use of GLP-1RAs, cancer recurrence, and all-cause mortality among cancer survivors versus the non-cancer population.
Results:Compared to the non-cancer population, the risk of all-cause mortality was significantly higher among cancer survivors (HR, 5.26; 95% CI, 5.01-5.52). After adjustment of potential confounders, ever use of GLP-1 RAs was significantly associated with a lower risk of all-cause mortality among all-type cancer survivors (HR, 0.36; 95% CI, 0.25-0.51), whereas the association was not significant among the non-cancer population (HR, 0.75; 95% CI, 0.47-1.21). For cancer survivors with certain types of cancer with known associations to obesity, similar associations were observed. On the contrary, ever use of GLP-1 RAs was not significantly associated with cancer recurrence among all-type cancer survivors (HR, 0.80; 95% CI, 0.50-1.30) or obesity-associated cancer survivors (HR, 0.60; 95% CI, 0.31-1.17).
Conclusion:In this study, a significant association between ever use of GLP-1 RAs and a lower risk of all-cause mortality was observed among cancer survivors but not among the population without cancer diagnoses. On the other hand, ever use of GLP-1 RAs was not significantly associated with cancer recurrence among cancer survivors. Further studies to investigate the application of GLP-1 RAs among cancer survivors are warranted.
Citation Format: Po-Hua Chen, Elizabeth A. Hibler. The associations between the use of GLP-1 receptor agonists, cancer recurrence and all-cause mortality among cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 735.