The Journal of clinical endocrinology and metabolismJan 3, 2026

GLP-1 Receptor Agonists Linked to Lower Death and Hospital Stay Rates in Cancer Patients

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jun 28, 2026

Abstract

Essence

In patients with diabetes and active cancer, GLP-1 receptor agonist use was linked to lower mortality and hospitalization than comparator diabetes treatments.

Evidence

This TriNetX retrospective cohort analysis compared 3,747 patients with type 2 diabetes who received GLP-1 receptor agonists within 3 months of starting systemic cancer therapy with 52,061 metformin-treated controls and found lower mortality overall (HR 0.875, 95% CI 0.778-0.985) and in new starters (HR 0.786, 95% CI 0.662-0.934), plus lower hospitalization, sepsis, major cardiovascular events, pulmonary embolism, and pneumonia.

Caveat

Because this was an observational database study with treatment selection confounding and BMI/A1c subgroup analyses that were not statistically significant, it does not prove GLP-1 receptor agonists caused the better outcomes.

Simplified

BACKGROUND: GLP- 1 RA have been reported to decrease cancer incidence, but less is known about their potential in patients with active cancer. Preclinical studies have demonstrated that GLP-1 RA inhibit progression of solid tumor malignancies via downregulation of cellular proliferation pathways and improved glycemic control. Despite these promising findings, studies characterizing the effects of GLP-1 RA in patients with active cancer are limited.

METHODS: Using TriNetX, a global database comprising over 120 million patients, we identified an overall cohort of 3747 patients with type 2 diabetes who received GLP-1 RA within 3 months of starting systemic therapy and identified 52,061 patients receiving metformin in the same timeframe as a control cohort. Additional sub-analyses stratified patients by hemoglobin A1c range, obesity, and by participants "newly started" on their first instance of GLP-1 RA within 3 months of starting cancer treatment.

RESULTS: Patients receiving GLP-1 RA had significantly reduced mortality in both the overall monotherapy setting (HR: 0.875, 95% CI: (0.778-0.985), p=0.0268) and the new start setting (HR: 0.786 , 95% CI: (0.662-0.934), p= 0.0062) cohorts. Secondary analyses found lower rates of all-cause hospitalization, sepsis, major adverse cardiovascular events, pulmonary embolism, and pneumonia in patients on GLP-1 RA. Sub-analyses stratified by BMI and A1c did not meet statistical significance.

CONCLUSIONS: Patients with diabetes and cancer who received GLP-1 RA experienced superior survival outcomes and reduced rates of hospitalization compared to patients receiving metformin. Additionally, patients already on metformin and newly started on GLP-1 RA demonstrated superior survival outcomes compared to patients newly started on insulin. Further prospective, well-controlled studies are needed to evaluate the benefits of GLP-1 RA in patients with diabetes and cancer.