ArticleThe oncologist2026
GLP-1 receptor agonist use and overall survival among women with type 2 diabetes and breast cancer: a retrospective cohort study.
Article in The oncologist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDiabetes and obesity are associated with worse prognosis in women with breast cancer. However, the impact of glucagon-like peptide-1 receptor agonists (GLP-1RA) on survival following breast cancer diagnosis remains unclear.
methodsWe conducted a single institution, propensity-score matched, retrospective, 2-year landmark study of women with type 2 diabetes (T2D) diagnosed with breast cancer at City of Hope (2009-2025). Patients were categorized based on post-diagnosis exposure to GLP-1RA. Patients were compared across exposure groups using t-tests for continuous variables, chi-square tests for categorical variables, multivariable Cox proportional hazards models for overall mortality risk, and Kaplan-Meier plots for survival time.
resultsIn 226 matched pairs, there were 47 deaths (30 in unexposed patients and 17 in exposed patients). GLP-1RA exposure was associated with a significantly lower risk of overall mortality (HR = 0.51, 95% CI 0.28-0.93, P = .03) on multivariable analysis. A sensitivity analysis in stage I-III patients yielded similar results (HR = 0.45, 95% CI 0.23-0.85, P = .01). Kaplan-Meier survival analysis also showed an association between increased overall survival and GLP-1RA exposure (log-rank P = .02).
conclusionsIn this retrospective cohort of women with T2D and breast cancer, GLP-1RA use after diagnosis was associated with improved overall survival in T2D. These findings reflect all-cause mortality and do not distinguish between cancer-specific and non-cancer causes of death and should therefore be interpreted accordingly.
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