GLP-1s Lead to Weight Loss, Improved CVD Outcomes in Breast Cancer

In abstracts presented at ASCO 2024, the annual meeting for the American Society of Clinical Oncologists, researchers discovered that glucagon-like peptide-1 receptor agonists (GLP-1RAs) were significantly beneficial in treating obesity among women with breast cancer. They also explored GLP-1RA use for anthracycline or HER-2 inhibitor-treated patients with breast cancer and diabetes, finding a reduction in major adverse cardiovascular events (MACE).^1,2

“Weight gain and obesity are significant problems for women receiving adjuvant therapy for breast cancer and obesity is associated with adverse breast cancer outcomes. In addition, obesity is associated with negative impact on overall physical and mental health. The GLP-1 agonists, semaglutide and tirzepatide, are effective in achieving weight loss and have been associated with decreased incidence of diabetes, stroke, and overall mortality in the non-diabetic as well as diabetic populations,” wrote Fischbach et al.¹

GLP-1s, such as semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro, Zepbound) have taken over as the highest-selling prescription drugs in the US. In 2023, for example, semaglutide overtook the cancer medication adalimumab as the highest-selling drug in the country, and experts predict that trend to continue through 2024.³

With ongoing trials to explore GLP-1 treatment beyond diabetes and weight loss, researchers at ASCO 2024 examined the drugs’ uses for patients with breast cancer. Analyzing GLP-1 efficacy in various cohorts, researchers presented their findings in the attempt of rapidly expanding GLP-1 research and data.

Researchers aimed to address GLP-1 use for weight loss and cardiovascular (CV) outcomes in women with breast cancer. “There are limited data on the efficacy and safety of GLP-1 agonists in women with breast cancer,” they wrote.¹

READ MORE: GLP-1s Improve Taste Sensitivity, Reduce Body Weight in Patients with Obesity

GLP-1s for Weight Loss Among Women with Breast Cancer

Researchers examined over 92,000 medical visits for 7149 patients. Using data from the Yale Cancer Center and Yale New Haven Health Network from 2017 to 2022, they performed a retrospective analysis of semaglutide and tirzepatide’s association with weight loss in patients with breast cancer at stage I, II, or III.¹

They gathered 5430 evaluable patients (mean age, 58 years) with non-metastatic disease and found that just 1.3% of the population was prescribed either semaglutide or tirzepatide.

The pretreatment mean weight was 95.8 kg (211.2 lbs) and mean body mass index (BMI) was 35.9 kg/m2. For patients treated with either GLP-1RA, mean weight loss was 3.03 kg (6.68 lbs), which accounted for a decrease of 1.1 for mean BMI. The mean maximal weight loss for semaglutide- or tirzepatide-treated patients was 8.89 kg (19.60 lbs), which accounted for a maximal reduction in BMI of 3.2.¹

“In this retrospective analysis, [GLP-1RAs] are associated with clinically meaningful weight loss in overweight and obese women with early breast cancer. Recurrence risk did not appear to be preliminarily impacted by treatment. Additional research is needed on long term safety as well as weight loss maintenance with these drugs in breast cancer survivors,” concluded authors of the abstract.¹

GLP-1s for CV Outcomes Among Women with Breast Cancer

Analyzing a much more specific study population, a second abstract addressed GLP-1 use among patients with breast cancer and diabetes also receiving anthracycline or HER-2 inhibitors.

“Anthracyclines or HER-2 inhibitors are associated with the potential for [MACE] among patients with breast cancer. Diabetes further increases the risk of MACE,” wrote the authors.²

Researchers included adult patients with breast cancer and type 2 diabetes that were previously prescribed anthracyclines or HER-2 inhibitors. Then, patients within this population were given a GLP-1 prescription and matched with a cohort receiving no GLP-1 and instead a second-line diabetes medication.

Among the study population, 724 patients receiving GLP-1s were matched with a non-GLP-1 group (median age, 60 years for both groups). “The prevalence of hypertension (81%), metastatic disease (61%), and radiation therapy (42%) was similar between cohorts, as was the use of anthracyclines and HER-2 inhibitors,” they continued.²

Compared with the non-GLP-1 group, those receiving GLP-1 treatment reported a reduced risk of MACE, heart failure hospitalization, and all-cause mortality.

“[GLP-1s] were associated with a reduction in major adverse cardiovascular events, incident heart failure and heart failure hospitalization, and all-cause mortality among anthracycline or HER-2 inhibitor-treated patients with breast cancer and [diabetes],” concluded the authors.²

Click here for more of our coverage from ASCO 2024.

Don’t get left behind: Sign up today for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips delivered straight to your inbox.

References

1. Fischbach NA, Zhou B, Deng Y, et al. Impact of semaglutide and tirzepatide administration on weight in women with stage I-III breast cancer. Presented at: ASCO 2024; May 30-June 3; Chicago, Il.

2. Chiang CH, Chang YC, Tang Z, et al. The impact of glucagon-like peptide 1 agonists on anthracycline or human epidermal growth factor receptor 2 inhibitor-associated cardiotoxicity in patients with breast cancer and diabetes mellitus. Presented at: ASCO 2024; May 30-June 3; Chicago, Il.

3. Enormous demand for weight-loss drugs drives up total U.S. prescription spending. American Society of Health System Pharmacists. April 24, 2024. Accessed June 18, 2024. https://www.prnewswire.com/news-releases/enormous-demand-for-weight-loss-drugs-drives-up-total-us-prescription-spending-302125178.html