An observational study on the usage of GLP-1 in breast cancer patients in the US.

Abstract

e13107 Background: Recent approvals of Glucagon-Like Peptide-1 (GLP-1) for weight loss have demonstrated their clinical benefit beyond Type 2 Diabetes (T2D) and generated extensive research on their potential use in other conditions – including certain cancers. In this study, we compare the profile of stage IIIb-IV drug-treated breast cancer (BC) patients who are receiving a GLP-1 versus those who are not. Methods: Ipsos’ Global Oncology Monitor is a multi-stakeholder, physician-reported syndicated patient record database. This analysis comprises 754 cancer-treating physicians in US, screened for seniority and caseload, submitting data on 29,497 patients, online, from April – September 2024. Results: Among the 3,479 stage IIIb-IV BC patients with known GLP-1 treatment status, 2% were currently receiving a GLP-1. Cytotoxic and/or hormonal-based treatments were common in this study population – and were being used to treat 84% of the patients with T2D and/or Obesity (with or without other comorbidities) who were taking a GLP-1; the prevalence of GLP-1 use in this subset of patients was 7%. Among patients with T2D and/or Obesity, those on GLP-1s were more likely to be treated with curative intent (39% vs. 21%). Those not receiving GLP-1s were more likely to be treated with intent to extend life (70% vs. 51%). Some differences in reasons for treatment selection are shown in the table. Patients receiving a GLP-1 were also less likely to be managed by physicians based in university/teaching hospitals (6% vs. 21% of those not GLP-1 treated). Conclusions: In this study, we observed low usage of GLP-1s, even though cytotoxic or hormonal-based regimens used to treat BC are known to cause weight gain. We also observed that, among GLP-1 patients where cure is a more likely treatment intent, ‘biomarker results’ was a central reason for treatment selection, while tolerability, important in the non-GLP-1 cohort, was given much lower consideration. Such differences may signify a need for data on GLP-1s’ efficacy, effect on cancer treatments and long-term safety profile, if they are to be used as a standard of care in BC. We also observed that patients receiving a GLP-1 were less likely to be from university/teaching hospitals, despite their typically adopting new treatment options faster than their non-academic counterparts. The high cost of GLP-1s, lack of insurance coverage for weight loss medications, and supply constraints may be barriers for these facilities. Further investigation using a comparator cohort is warranted. Ranking of top 5 reasons for selecting current anti-cancer treatments among drug-treated stage IIIb-IV BC patients with T2D and/or obesity (Note: out of a total of 16 reasons; multi-selection allowed). Reasons Patients receiving GLP-1(n=49) Patients not receiving GLP-1(n=738) Biomarker results 1 6 Prevent progression 2 3 Approved standard of care 3 2 Proven efficacy 4 1 Proven experience 5 4 Well tolerated 8 5