GLUCAGON-LIKE peptide-1 receptor agonists (GLP-1RAs) do not appear to increase the risk of recurrence or progression in patients with well differentiated thyroid cancer (DTC), according to new retrospective cohort data from a tertiary care centre in New York.
Study Design and Patient Cohort
Investigators conducted a retrospective observational cohort study including 1,072 patients with DTC, of whom 536 had been exposed to GLP-1RA therapy and 536 were never exposed. Patients were matched 1:1 by age, date of DTC diagnosis, TNM stage, body mass index (BMI), and presence of diabetes mellitus. The study employed a multistate model to evaluate the impact of GLP-1RA as a time dependent variable on transitions from a “no or stable disease” state to “recurrence or progression.”
The cohort had a median age of 49 years, with 71% female, 54% with diabetes mellitus, and mean BMI of 35 ± 7 kg/m². Most patients (84%) had American Joint Committee on Cancer stage I disease, and 58% were at intermediate or high risk of recurrence according to American Thyroid Association criteria. Median GLP-1RA exposure was 16 months and follow up duration was 69 months.
Outcomes And Statistical Analysis
Multivariable analysis adjusted for age, ATA risk, radioactive iodine therapy, and diabetes mellitus showed that GLP-1RA use was not significantly associated with disease recurrence or progression. In the survival cohort, the hazard ratio was 0.87 (95% confidence interval: 0.62–1.21; P = 0.39), while in the full cohort, the hazard ratio was 0.75 (95% confidence interval: 0.54–1.03; P = 0.07). These findings suggest no statistically significant effect of GLP-1RAs on the natural course of DTC.
Clinical Implications
The study provides reassurance that eligible patients with DTC can receive GLP-1RA therapy for diabetes mellitus or obesity without increasing their risk of thyroid cancer recurrence or progression. Clinicians should consider the cardiometabolic benefits of GLP-1RA when clinically indicated, without undue concern for adverse oncological outcomes in well differentiated thyroid cancer.
Reference
Patrizio A et al. Exposure to GLP-1RA and risk of structural progression in differentiated thyroid cancer. J Clin Endocrinol Metab. 2026:dgag051.
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