Semaglutide reduced major adverse cardiovascular events by up to 26% and showed no significant increase in cancer risk, with some evidence of reduced risk for specific cancers including gastrointestinal cancer (HR 0.45), in adults with type 2 diabetes or obesity.
Does semaglutide increase the risk of cancer or mitigate cardiotoxicity in patients with T2DM and obesity?
Semaglutide maintains a highly favorable benefit-risk profile, with reassuring human data regarding cancer risk and potential new applications in mitigating anticancer therapy-induced cardiotoxicity.
Effect estimate: Reduction in MACE up to 26% in clinical trials; Cancer incidence OR 0.95 (95% CI 0.62–1.45) for overall neoplasms; OR 0.25 (95% CI 0.03–2.24) for pancreatic cancer; OR 2.04 (95% CI 0.33–12.61) for thyroid cancer; HR 0.45 (95% CI 0.37–0.53) for gastrointestinal cancer (protective effect)
Introduction: Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), has demonstrated unprecedented efficacy in the treatment of type 2 diabetes mellitus (T2DM) and obesity. However, its rapid clinical widespread use has ignited a debate regarding long-term safety, particularly concerning the risk of specific neoplasms and its ability to modulate cardiovascular health, not only as primary prevention but also as a potential agent to mitigate cardiotoxicity. Objectives: This narrative review aims to analyze the most recent evidence from clinical trials and post-marketing surveillance to evaluate the correlation between semaglutide use and the incidence of cancer, as well as the drug’s efficacy in reducing cardiotoxicity induced by anticancer therapies. Results and Discussion: While preclinical rodent models suggested a link to medullary thyroid carcinoma, human epidemiological data remain reassuring, though caution is advised in patients with genetic predisposition. Regarding pancreatic cancer, current meta-analyses do not confirm a significant increase in risk, suggesting that metabolic benefits outweigh potential concerns. Conclusions: Semaglutide is confirmed as a therapeutic tool with a highly favorable benefit–risk profile. While oncological monitoring must continue, the drug’s cardioprotective and anti-inflammatory properties open new frontiers not only in metabolic management but also in safeguarding cardiovascular integrity in complex clinical scenarios.
Correra et al. (Tue,) conducted a review in Adults with type 2 diabetes mellitus or obesity, including those with preexisting cardiovascular disease and those without diabetes. Semaglutide vs. Placebo or other antidiabetic drugs was evaluated on Incidence of major adverse cardiovascular events (MACE) and incidence of cancers including pancreatic, thyroid, and overall neoplasms (Reduction in MACE up to 26% in clinical trials; Cancer incidence OR 0.95 (95% CI 0.62–1.45) for overall neoplasms; OR 0.25 (95% CI 0.03–2.24) for pancreatic cancer; OR 2.04 (95% CI 0.33–12.61) for thyroid cancer; HR 0.45 (95% CI 0.37–0.53) for gastrointestinal cancer (protective effect)). Semaglutide reduced major adverse cardiovascular events by up to 26% and showed no significant increase in cancer risk, with some evidence of reduced risk for specific cancers including gastrointestinal cancer (HR 0.45), in adults with type 2 diabetes or obesity.