PATIENTS with brain metastases and Type 2 diabetes using glucagon-like peptide-1 receptor agonists (GLP-1RA) have a near 40% lower risk of death over 3 years compared with nonusers, a 2026 retrospective cohort study has found.
Comorbid Type 2 Diabetes Can Worsen Brain Metastases Outcomes
Brain metastases are secondary tumours that form in the brain when cancer cells spread from their original site.
They are associated with high rates of morbidity and mortality.
Comorbid Type 2 diabetes can worsen the relevant outcomes through metabolic and inflammatory pathways, which GLP-1RAs could combat through their potential neuroprotective and anti-inflammatory effects.
GLP-1RAs Were Associated with a 37% Lower Risk of Death
Researchers identified 850 adult patients with brain metastases and Type 2 diabetes between 1 January 2018 and 1 January 2024.
All were prescribed GLP-1RAs within 6 months before their first diagnosis of brain metastases and Type 2 diabetes.
The authors excluded those with lower socioeconomic status or potential contraindications to GLP-1RAs.
The weight loss drugs were associated with a 37% lower risk of death.
The benefit was consisted across major cancer types and different GLP-1RAs, excluding liraglutide.
GLP-1RAs exhibited the same advantage when pitted against other antidiabetic therapies.
Study Design Limited Causal Inference and Generalisability
Due to the study design, researchers warned that causal inference is limited.
They were also confronted with a lack of some specific patient details, meaning that, for example, dose-response analyses could not be carried out.
Finally, it was also noted that healthcare organisations within the database used (TriNetX) are mostly academic hospitals. Again, generalisability to non-academic settings is limited.
Future prospective studies should further investigate the specific effects of GLP-1RAs in patients with cancer, researchers reported.
References
Chi K-Y et al. GLP-1 receptor agonist use and survival among patients with Type 2 diabetes and brain metastases. JAMA Netw Open. 2026;DOI:10.1001/jamanetworkopen.2026.1311.
Mayo Clinic. Brain metastases. 2024. Available at: https://www.mayoclinic.org/diseases-conditions/brain-metastases/symptoms-causes/syc-20350136. Last accessed: 14 March 2026.
Boire A et al. Brain metastasis. Nat Rev Cancer. 2020;20(1):4-11.
Farmaki P et al. Complications of the type 2 diabetes mellitus. Curr Cardiol Rev. 2020;16(4):249-251.
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