OBJECTIVE: To evaluate the association between glucagon-like peptide-1 receptor agonist (GLP-1RA) use and all-cause mortality in women with ovarian cancer, using real-world data from a global federated health database.
METHODS: We conducted a retrospective cohort study using the TriNetX global health records network. Female patients diagnosed with ovarian cancer between 2014 and 2023 were included. Patients were divided into two cohorts based on GLP-1RA exposure. A 1:1 propensity score matching was performed to balance demographics, comorbidities, medications, and cancer stage. Kaplan-Meier survival curves and Cox proportional hazards models were used to estimate overall survival. Subgroup and sensitivity analyses were performed.
RESULTS: After matching, 1023 patients were included in each group. GLP-1RA users had a significantly lower all-cause mortality rate compared with non-users (7.94 % vs. 19.71 %; hazard ratio [HR], 0.45; 95 % confidence intervals [CI], 0.35-0.59; log-rank P < 0.001). The survival benefit was consistent across most subgroups, including patients receiving chemotherapy or Poly(ADP-ribose) polymerase (PARP) inhibitors. No significant benefit was observed in patients with heart failure or chronic kidney disease. Sensitivity analysis supports the primary analysis.
CONCLUSIONS: Use of GLP-1RA was associated with substantially improved overall survival in women with ovarian cancer. Given their widespread clinical use and favorable safety profile, GLP-1RA may represent a promising adjunctive strategy for improving outcomes in women with ovarian cancer, particularly those with coexisting metabolic disorders. Further prospective studies are warranted.
