Emily Menendez

GI Oncology Now

The US Food and Drug Administration approved the use of glucagon-like peptide 1 receptor agonists (GLP-1RAs) in 2005 as a treatment for type 2 diabetes (T2D). The drug helps lower blood sugar levels and can aid in weight loss.As a high body-mass index is a contributing risk factor for colorectal cancer (CRC), GLP-1RAs may be associated with a decreased risk of CRC in patients with T2D compared with other antidiabetic drugs.To corroborate this theory, Dr. Lindsey Wang and colleagues conducted a nationwide, retrospective, cohort study in drug-na&iuml;ve patients with T2D to <a href="https://jamanetwork.com/journals/jamaoncology/fullarticle/2812769" target="_blank" rel="noopener">compare the efficacy of GLP-1RAs against 7 other non-GLP-1RA antidiabetic medications.</a>Researchers analyzed data from 1,221,218 patients with T2D who were prescribed antidiabetic medications between 2005 and 2019. Patients had no prior CRC diagnosis or antidiabetic drug usage. Data were collected using the TriNetX platform, which provides de-identified patient data from a collection of health care organizations.Exposure and comparison treatment arms were created for each drug comparison: GLP-1RAs versus insulin, metformin, alpha-glucosidase inhibitors, dipeptidyl-peptidase 4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, sulfonylureas, and thiazolidinediones.Outcomes were defined as the first diagnosis of CRC that occurred within 15 years of a patient&rsquo;s first prescription of GLP-1RAs or another antidiabetic drug. Data were collected in September 2023. GLP-1RAs were found to correlate with a decreased risk of CRC compared with insulin (hazard ratio [HR], 0.56; 95% CI, 0.44-0.72), metformin (HR, 0.75; 95% CI, 0.58-0.97), SGLT2 inhibitors, sulfonylureas, and thiazolidinediones and provided a lower, but not statistically significant, risk compared with alpha-glucosidase and DPP-4 inhibitors. GLP-1RAs were associated with a lower risk of CRC in patients with obesity compared with insulin (HR, 0.50; 95% CI, 0.33-0.75), metformin (HR, 0.58; 95% CI, 0.38-0.89), and other antidiabetic drugs.While this study points to GLP-1RAs providing a lower risk of CRC in patients with obesity compared with other antidiabetics, the study&rsquo;s limitations included potential unmeasured or uncontrolled confounders, self-selection, reverse causality, and other biases inherent in observational studies.Validation is needed from other data and study populations, and further research is warranted to determine the effects of GLP-1RAs on other obesity-associated cancers and in patients who have received prior antidiabetic treatments.

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As a high body-mass index is a contributing risk factor for colorectal cancer, GLP-1RAs may offer a decreased risk of CRC in patients with T2D.