Impact of incretin mimetic therapy on weight change in patients with cancer: A pan-cancer analysis from a single institutional cohort.

Abstract

10598 Background: An elevated body mass index (BMI) is a frequent comorbidity in patients with cancer. Chemotherapy can exacerbate metabolic dysfunction and weight gain, further complicating cancer management. Glucagon-like peptide-1 receptor agonists (GLP-1RA) are indicated for the treatment of diabetes (DM) and obesity, promoting weight loss through mechanisms such as insulin secretion, delayed gastric emptying, and reduced appetite. However, their effect after a cancer diagnosis, particularly during chemotherapy, remains underexplored. Methods: This was a single-institution retrospective study evaluating cancer patients prescribed GLP-1 receptor agonists (GLP-1RA). Patient demographics, cancer type (solid vs. hematologic), and treatment details were extracted from the medical records. The overlap between GLP-1RA therapy and chemotherapy administration was recorded. Changes in BMI were analyzed using descriptive statistics, including percentiles and median values. A one-sample t-test assessed the overall significance of BMI changes, while subgroup analyses using Welch two-sample t-tests evaluated the impact of chemotherapy, sex, and cancer type on BMI reduction. R software was used to perform statistical analyses. Results: Between 2015 and 2024, 339 cancer patients were treated with GLP-1RAs, mainly semaglutide (48%) and liraglutide (28%). DM was the primary indication in 92% patients (Table 1). The median age at initiation was 60.8 years (range: 19.0–88.2), for a median duration of 11.8 months (range: 2.6–94.1). Median BMI decreased from 32.5 kg/m² (range: 18.9–58.9) pre-treatment to 31.5 kg/m² (range: 16.6–60.2) on/post-treatment, with a median change of -1.0 kg/m² (95%CI: -1.64, -1.01) and a median percentage reduction of -3.71% (95%CI: -4.59%, -2.83%). Subgroup analyses showed significant BMI reductions in patients receiving chemotherapy (median: -4.18%, 95%CI: -6.38%, -2.82%) and those not receiving chemotherapy (median: -2.32%, 95%CI: -4.32%, -2.31%), with no significant difference between the groups (95%CI: -0.22, 1.28). Additionally, BMI reductions were consistent across sex (95%CI: -0.91, 0.36) and cancer type (solid vs. hematologic, 95%CI: -0.77, 0.64). Conclusions: GLP-1RA use resulted in weight loss in cancer patients independent of chemotherapy exposure, sex, or cancer type. Although the degree of weight loss was modest, findings were consistent with GLP1-RA treatment dosed for a diabetes indication. These findings support the need for clinical trials evaluating incretin mimetics for weight management and their potential impact on cancer-specific outcomes. Patient demographics. Variable: # of Patients ( n ): %: Sex: F / M 180 / 156 54 / 46 White 171 61 Black 56 20 Asian 20 7 Other Race or Unknown 34 12 Solid Tumor 249 74 Hematological Cancer 87 26 Chemotherapy During GLP-1RA 103 30 GLP-1RA Use for DM Indication 313 92