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Publications

Journal Article Review Ahead of print

PubMed: 42823599 DOI: 10.1111/obr.70231

Incretin-Based Therapy in Patients with Malignancy and Obesity or Type 2 Diabetes. An Italian Association of Medical Oncology (AIOM), Italian Association of Medical Diabetologists (AMD), Italian Society of Diabetology (SID), Italian Society of Endocrinology (SIE), Italian Society of Pharmacology (SIF), and Italian Society of Obesity (SIO) Position Paper.

Obes Rev

Authors: Antongiulio Faggiano, Antonella Argentiero, Giulia Borghesani, Jonida Haxhi, Stefania Camastra, Saverio Cinieri, Alessio Cortellini, Marzia Del Re, Marco Gallo, Annalisa Natalicchio, Dario Giuffrida, Stefania Gori, Valerio Gristina, Matteo Monami, Lelio Mordivucci, Alberto Ragni, Cristiana Randazzo, Valerio Renzelli, Laura Sciacca, Dalila Tessitore, Maria Chiara Zatelli, Massimo Di Maio, Rocco Barazzoni, Nicola Marrano, Diego Ferone, Nicola Silvestris, Francesco Giorgino

Affiliations

  • Endocrinology Unit, Department of Clinical & Molecular Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, Rome, Italy.
  • Medical Oncology Department, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
  • Section of Innovation Biomedicine-Oncology Area, Department of Engineering for Innovation Medicine, University of Verona and Verona University and Hospital Trust (AOUI), Verona, Italy.
  • Medical Oncology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.
  • Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Medical Oncology Division and Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, Brindisi, Italy.
  • Operative Research Unit of Medical Oncology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
  • Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
  • Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, UK.
  • Saint Camillus International University of Health and Medical Sciences, Rome, Italy.
  • Endocrinology and Metabolic Diseases Unit, Azienda Ospedaliero-Universitaria SS Antonio e Biagio e Cesare Arrigo of Alessandria, Alessandria, Italy.
  • Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
  • Department of Oncology, Istituto Oncologico del Mediterraneo, Viagrande, Catania, Italy.
  • Medical Oncology Unit, Department of Precision Medicine in Medical, Surgical and Critical Care, AOUP Paolo Giaccone University Hospital, University of Palermo, Palermo, Italy.
  • Diabetology, Careggi Hospital and University of Florence, Florence, Italy.
  • Diabetology and Nutrition Unit, Department of Medical Specialties, ASL Roma 1 - S. Spirito Hospital, Rome, Italy.
  • Unit of Clinical Nutrition, Obesity and Metabolic Diseases, University Hospital Policlinico "P. Giaccone", Palermo, Italy.
  • Diabetologist and Endocrinologist, Italian Association of Clinical Diabetologists, Rome, Italy.
  • Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania, Catania, Italy.
  • Section of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
  • Department of Oncology, University of Turin, AOU Città della Salute e della Scienza, Turin, Italy.
  • Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
  • Endocrinology Unit, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova, Genoa, Italy.

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as pivotal agents in the treatment of type 2 diabetes (T2D) and obesity, with well-established metabolic and cardiovascular benefits that translate into improvement in quality of life and life expectancy. While a potential benefit may also be hypothesized in patients with metabolic disorders and malignancy, robust clinical evidence is still lacking. In recent years, attention has turned to their potential impact on cancer risk, although current evidence remains limited and, in some cases, conflicting. Several biological pathways, such as improvements in insulin sensitivity, reductions in chronic inflammation, modulation of cellular signaling, and changes in the tumor microenvironment, have been proposed as possible mechanisms through which GLP-1RAs might influence cancer development or progression. However, available data derive from preclinical or observational studies, and high-quality prospective clinical evidence is still lacking. While some reports suggest possible protective associations in specific cancer types, others raise concerns about potential risks, particularly in hormonally sensitive or receptor-expressing tissues. This position paper synthesizes available data on the oncologic safety and potential antitumor effects of GLP-1RAs, highlights key knowledge gaps, and discusses clinical implications, underscoring the need for further research to clarify their role in cancer prevention and treatment.

MeSH

Diabetes Mellitus, Endocrinology, Neoplasms, Pharmacology, Obesity, Incretins, Therapeutics, Medical Oncology, Drug Interactions, Diabetes Mellitus, Type 2