ArticleJAMA network open2026
Survival and Recurrence With GLP-1 Receptor Agonists in Breast Cancer.
Article in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- The Possible Hematological Cost of Metabolic Success: Do Incretin-Based Therapies Silently Trigger Anemia?Medical sciences (Basel, Switzerland) · 2026Review
- GLP-1 Receptor Agonists and Obesity Related Cancers: What We Know So Far.Current oncology reports · 2026Review
- GLP-1 receptor agonist use and overall survival among women with type 2 diabetes and breast cancer: a retrospective cohort study.The oncologist · 2026Article
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Authors and funding
12 authors.
Funding
Abstract
Importance: Patients with breast cancer (BC) with comorbid obesity or type 2 diabetes (T2D) experience poorer survival. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are approved to treat these comorbidities; however, their associations with BC survival and recurrence remain unclear. Objective: To evaluate the association between GLP-1 RA use and 10-year all-cause mortality and recurrence-free survival (RFS) over the 10-year follow-up period, as well as 5- and 10-year all-cause mortality and RFS probabilities among patients with BC. Design, Setting, and Participants: This retrospective cohort study used TriNetX US Collaborative Network data from women (≥18 years) with BC from 68 health care organizations who received a diagnosis between April 1, 2006, and April 1, 2023. Propensity score matching balanced characteristics. Data were analyzed between September 16 and October 3, 2025. Exposures: GLP-1 RA use (≥2 prescriptions) during the 6 months before and any time after the index diagnosis; nonuse (0 entries). Main Outcomes and Measures: The primary outcome was all-cause mortality, and the secondary outcome was RFS. Cox proportional hazards regression model-estimated hazard ratios (HRs) were restricted to 10 years. Kaplan-Meier estimators were used to calculate 5- and 10-year all-cause mortality and RFS probabilities. Prespecified subgroup (postmenopausal) and landmark (6- and 12-month) analyses were conducted. Results: The study comprised 841 831 eligible patients with BC (mean [SD] age, 69.1 [12.2] years). After exclusions and 1:1 propensity score matching, 3 cohorts were identified: 1610 patients for GLP-1 RA use vs nonuse (patients with obesity [body mass index ≥30]), 2323 patients for GLP-1 RA use vs insulin or metformin (patients with T2D), and 4052 patients for GLP-1 RA use vs sodium-glucose cotransporter 2 inhibitors (patients with T2D). Among patients with obesity, GLP-1 RAs were associated with lower hazard of all-cause mortality (HR, 0.35; 95% CI, 0.21-0.58; P < .001) and RFS (HR, 0.44; 95% CI, 0.30-0.64; P < .001) over a 10-year follow-up period. Among patients with T2D, GLP-1 RAs vs insulin or metformin were associated with lower hazard of all-cause mortality (HR, 0.09; 95% CI, 0.06-0.15; P < .001) and RFS (HR, 0.33; 95% CI, 0.21-0.50; P < .001). No significant differences were observed between GLP-1 RA and sodium-glucose cotransporter 2 inhibitor groups. Subgroup and landmark analyses yielded similar findings. Conclusions and Relevance: In this cohort study of patients with BC, findings suggested a potential association between GLP-1 RA use and improved outcomes among patients with BC who have obesity and related metabolic conditions. These findings support further evaluation of GLP-1 RA therapy in randomized clinical trials.
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