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Abstract Context Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as effective therapies for diabetes mellitus and obesity. Their effect on nonmedullary thyroid malignancies remains unclear. Objective To evaluate the impact of GLP-1RA exposure on tumor kinetics of patients with low-risk papillary thyroid carcinoma undergoing active surveillance (AS). Design Retrospective observational cohort study of 18 patients with 19 papillary thyroid carcinomas (≤1.5 cm) exposed to GLP-1RA matched 1:2 by body mass index and tumor size to 37 patients with 38 carcinomas never exposed to GLP-1RA and undergoing AS at a single tertiary center for a median of 5.5 years. Main outcome Tumor growth/shrinkage was considered significant when any diameter changed by ≥3 mm and/or volume changed 72%. Tumor volume doubling time was calculated in a subset of patients off and on GLP-1RA therapy. Results After a median GLP-1RA exposure of 25 months interquartile range: 14-34 and a median follow-up of 5.5 years, 2/19 (10.5%) tumors exposed to GLP-1RA exhibited significant volume growth, 1 (5.3%) decreased, and 16 (84.2%) remained stable, whereas 1/38 (2.6%) carcinomas not exposed to GLP-1RA showed 72% volume increase, 2/38 (5.3%) decreased, and 35/38 (92.1%) remained stable, P = .53. GLP-1RA exposure did not alter tumor volume growth kinetics in either of the 2 tumors that increased over time. Conclusion GLP-1RA therapy does not affect tumor growth kinetics in patients with low-risk papillary thyroid carcinoma on AS. Further studies with larger cohorts and extended follow-up are warranted to validate the safety of GLP-1RA use in patients with thyroid carcinomas undergoing active surveillance.
Patrizio et al. (Thu,) studied this question.