e12731 Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used in patients with type 2 diabetes mellitus (T2DM) and have been hypothesized to influence cancer-related outcomes. However, real-world data on survival and hospitalization outcomes among patients with breast cancer and diabetes treated with GLP-1 RAs remain limited. Methods: We conducted a retrospective cohort study using the TriNetX U.S. Collaborative Network. Adult women with non-metastatic breast cancer and T2DM diagnosed between January 1, 2010, and January 1, 2020, were identified. The index event was breast cancer diagnosis. Patients were stratified by GLP-1 RA initiation within one year after breast cancer diagnosis. Patients with metastatic disease or other primary malignancies were excluded. Before matching, 988 patients treated with GLP-1 RAs and 34,228 patients not treated with GLP-1 RAs were identified. Propensity score matching (1:1) was performed based on demographics, comorbidities, diabetes medications (e.g., insulin, metformin), cancer-related therapies, cancer hormonal status, endocrine treatment, and body mass index, resulting in 428 patients in each cohort. Outcomes were assessed up to five years following breast cancer diagnosis. Primary outcomes were all-cause mortality and hospitalization. Results: After propensity score matching, baseline characteristics were well balanced between cohorts, with a mean age of 75.2 years (standard deviation 8.1 years). The median follow-up was 3.8 years. During follow-up, death occurred in 38 patients (8.9%) in the GLP-1 RA cohort compared with 53 patients (12.4%) in the non-GLP-1 RA cohort. GLP-1 RA use was associated with a trend toward reduced mortality (hazard ratio HR 0.70, 95% CI 0.46–1.06; log-rank p = 0.09). Hospitalization occurred in 118 patients (27.6%) in the GLP-1 RA cohort and 159 patients (37.1%) in the non-GLP-1 RA cohort. GLP-1 RA use was associated with a statistically significant lower risk of hospitalization (HR 0.67, 95% CI 0.53–0.85; log-rank p = 0.001), with a number needed to treat of 11 to prevent one hospitalization over five years. Conclusions: In this propensity score-matched real-world cohort of women with non-metastatic breast cancer and type 2 diabetes, GLP-1 RA use initiated within one year of breast cancer diagnosis was associated with a significantly lower risk of hospitalization and a trend toward improved overall survival. These findings warrant further prospective investigation into the potential role of GLP-1 RA therapy in this population.
Habbas et al. (Thu,) studied this question.