The growing popularity of Ozempic and other GLP-1s in recent years is garnering greater attention from oncologists interested in how these drugs could affect cancer care and cancer rates.
Though the class of medication has been around for years, its use hadn't become widespread until the introduction of Ozempic and Wegovy, Nia Mitchell, MD, a medical weight management specialist at Durham, N.C.-based Duke Health, told Becker's. Currently, GLP-1 drugs are only covered by insurance for patients with diabetes and can cost around $1,000 for a one-month supply. However, recent research is showing the drugs can aid in care beyond diabetes, including heart disease and kidney disease.
However within oncology, these drugs haven't driven any large changes in the way cancer is treated, nor are they likely to alter treatment protocols immediately, Steven Artandi, MD, PhD director of the Stanford (Calif.) Cancer Institute, told Becker's.
"The obesity epidemic poses a real threat to our collective efforts to reduce cancer mortality, especially in this decade and beyond, as obesity has increased over the last 10 to 20 years," he said. "The finding that Ozempic and GLP-1 drugs can potentially reduce cancer risk by reducing obesity is pretty exciting because it's a potential partial solution."
Large impacts on cancer care may not be likely, but oncologists and leaders are still considering some nuances to care when treating cancer patients on GLP-1 drugs.
Minor complications in care
GLP-1 drugs do not have any known interactions with cancer therapies or radiation. However, they can affect patients in need of surgery, Sara Jo Grethlein, MD, executive director of the Swedish Cancer Institute in Seattle, told Becker's. The drugs can delay gastric emptying so, ideally, patients should stop taking them for two weeks before surgery., "However, in the cancer world, many of our surgeries are urgent, so patients might not always be able to withhold the medication for the full two weeks."
Beyond surgery, the lack of coverage for weight loss drugs can also cause delays in care for some.
"For example, I have a patient with a history of breast cancer who wants breast reconstruction," Dr. Mitchell said. "She needs to lose weight before she can have the reconstruction, but her insurance won't cover the medication because she doesn't have diabetes. This is making her weight-loss journey longer without the medication's help, which she feels is unfair."
Causing or preventing cancer
Recent research has made waves in oncology after suggesting that GLP-1 drugs could lower the risk of some cancers, but heighten the risk of thyroid cancer.
A recent study found GLP-1 drugs may lower the risk of developing certain obesity-related cancers. Researchers found people with Type 2 diabetes who were being treated with the medications were significantly less likely to develop 10 of 13 obesity-associated cancers than those taking insulin, according to a new study from researchers at Case Western Reserve University in Cleveland.
"However, it's not clear if the reduction in cancer risk is due to the drugs themselves or the weight loss they cause," Dr. Grethlein said. "Even though surgery leads to more weight loss than GLP-1 drugs, the drugs had a bigger reduction in cancer risk and all-cause mortality. This raises intriguing questions about how much of the benefit is due to weight loss versus something inherent to the drugs themselves."
A different study found that GLP-1s can increase risk of thyroid cancer in mice, but the results are not yet conclusive.
"We haven't had enough time to see the possible long-term negative outcomes," Dr. Mitchell said. "We need to keep an eye on it in the future. Right now, we see that people who can tolerate them benefit, but not everyone can due to side effects."
Even with minor complications, experts told Becker's they are excited about the possible interventions and what it could mean for the field.
Readers interested in the effects of GLP-1s on health systems and questions about their role in care delivery over the next 18 months are invited to join Becker's for a complimentary editorial webinar on this topic. Sign up here.