As glucagon-like peptide-1 receptor agonists (GLP-1RA) appear to be taking over the world, research using real-world data (RWD) is showing their potential in oncology beyond their existing benefit in type 2 diabetes and obesity.
At the American Society of Clinical Oncology (ASCO) meeting 2026, several studies evaluating GLP-1RAs in cancer patients signalled that they may improve overall survival (OS).
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One such study was run by Dr Jess Paulus, senior director of real-world research at Harvard University, and RWD and pharmacoepidemiologist leader at Ontada. Paulus was part of a research team that looked into the use of GLP-1RAs in oncology patients and their impact on key oncology endpoints, including OS.
The study analysed RWD from the US Oncology Network and included patients who had one of six different solid tumour types.
Patients were classified as GLP-1RA users if it was included in their medical record as a prescription. This, Paulus admitted, was one of the biggest limitations as only oncology medical records were observed. Following this, they identified around 400 GLP-1RA users.
The researchers found almost a 35% reduction in the rate of death among GLP-1RA users versus non-users.
“This was robust”, Paulus said. “We tried two or three different approaches to confounding control. We know there’s bias in this work, but regardless of what approach we took, we got basically the same answer.”
Paulus pointed to biological evidence that suggests that GLP-1RAs can have benefit in cancer as they reduce inflammation and glycaemic availability as well as having an anti-proliferative effect on tumour cells.
Paulus, who presented the data at ASCO, said that some oncologists raised concerns about the amount of weight loss patients would experience with GLP-1RAs, prompting the question of which oncology indications these drugs would be best suited to.
“Anorexia is associated with so many cancer types, especially advanced ones, and so this just feels like a drug that is completely contraindicated in many cancers. I think we are a long way from understanding which patients would most benefit, but this is a really pressing clinical question,” Paulus said.
“A lot of the signals that are coming out from others’ research mirror our study, which is very interesting. I’m not saying that we found a cause and effect, but the fact that a lot of competing teams using different data sources are getting the same answer is really provocative,” Paulus concluded.
Two other studies in this same field were presented at ASCO. Penn Medicine’s study was a retrospective analysis of GLP-1RA use and breast cancer incidence in women with BMI ≥25 aged 45–80.
The data demonstrated a 30% reduction in breast cancer incidence across a large real-world cohort, with the benefit holding independent of BMI.
The Cleveland Clinic, meanwhile, investigated GLP-1RA use and metastatic progression across obesity-related solid tumours through real-world analysis using the TriNetX database.
In this study, there was a 34% mortality reduction and identifying high tumour GLP-1R expression as an independent survival predictor, implicating direct receptor-mediated anti-tumour signalling on cancer cells themselves, separate from any systemic metabolic effect.
GlobalData analysts believe that if this response is confirmed in other studies, GLP-1RAs could represent an entirely new preventive and adjunctive treatment in multiple solid tumours.
GlobalData has produced a report for the main highlights of ASCO and a webinar will be held on 25 June, hosted by analysts Jack Cuthbertson and Selena Yu.
GlobalData is the parent company of Clinical Trials Arena.
