Association Between GLP-1 Receptor Agonists and Reduced Mortality in Older Cancer Patients with Type 2 Diabetes

A recent study has revealed that the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is associated with lower all-cause mortality rates in older patients suffering from both cancer and type 2 diabetes (T2D). This finding was published online in JAMA Network Open on July 18, 2025.

The research, conducted by a team from the University of Florida in Gainesville, focused on the comparative effectiveness of GLP-1 RAs against other diabetes medications, specifically sodium-glucose cotransporter-2 inhibitors (SGLT2is) and dipeptidyl peptidase-4 inhibitors (DPP4is). The study utilized Medicare data collected between 2013 and 2020, examining a cohort of patients aged 66 and older who had T2D and were diagnosed with one of nine specified cancers, including thyroid, pancreatic, bladder, colorectal, lung, kidney, breast, endometrial, or prostate cancer.

To mitigate confounding factors, the researchers employed propensity score matching, creating two distinct cohorts: one comparing GLP-1 RA users to SGLT2i users, and another comparing GLP-1 RA users to DPP4i users. In total, there were 2,553 matched pairs in the GLP-1 RA versus SGLT2i cohort, and 2,564 matched pairs in the GLP-1 RA versus DPP4i cohort.

While the study did not identify any significant differences in mortality risk between users of GLP-1 RAs and SGLT2is, a notable reduction in mortality was observed among those using GLP-1 RAs compared to DPP4is, with a hazard ratio of 0.60 indicating a 40% decrease in the risk of death.

In subgroup analyses, the survival advantages of GLP-1 RAs were consistent across various demographic factors including age, gender, and ethnicity, as well as across several types of cancer such as colorectal, lung, and breast cancers.

The authors of the study stated that while causality cannot be definitively established from their findings, the results provide new insights into the effectiveness of GLP-1 RAs and suggest that the observed differences in survival rates may be attributed to the specific systemic effects associated with this class of medications.

It is important to note that several researchers involved in the study disclosed affiliations with the biopharmaceutical industry, which may warrant further scrutiny regarding potential influences on the research outcomes.

For further details, refer to the complete study published in JAMA Network Open.