GLP-1 Medications Linked to Potential Reduction in Circulating Tumor DNA in breast Cancer Patients, But Access Disparities Exist
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A recent study presented at the san Antonio Breast Cancer Symposium (SABCS) 2025 suggests that glucagon-like peptide-1 (GLP-1) receptor agonists – medications initially developed for type 2 diabetes and weight loss – may be associated with reduced circulating tumor DNA (ctDNA) in patients with breast cancer. However, the research also highlights notable disparities in access to these medications based on sociodemographic factors and social determinants of health (SDOH).
What are GLP-1 Receptor Agonists?
GLP-1 receptor agonists are a class of drugs that mimic the effects of the naturally occurring hormone GLP-1. They work by stimulating insulin release, suppressing glucagon secretion, slowing gastric emptying, and promoting a feeling of fullness. Commonly prescribed GLP-1 medications include semaglutide (Ozempic, Wegovy) and liraglutide (Victoza, Saxenda). While primarily used for managing type 2 diabetes and obesity, growing research is exploring their potential benefits in other conditions, including cancer. https://www.mayoclinic.org/drugs-supplements/semaglutide/description/drg-20489998
Study Findings: GLP-1 Use and Tumor Activity
The real-world investigation, one of the largest of its kind, analyzed data from a large cohort of breast cancer patients. Researchers found that GLP-1 use was associated with:
* Increased ctDNA Testing: Patients taking GLP-1 medications were more likely to undergo ctDNA testing (2.8% vs. 1.5%).
* Lower ctDNA Positivity: A lower percentage of patients on GLP-1s tested positive for ctDNA (25.8% vs. 31.6%).
ctDNA is a marker of cancer activity; its presence in the bloodstream indicates that tumor cells are releasing DNA fragments. lower ctDNA positivity suggests a potential reduction in circulating tumor material, hinting at a possible anti-cancer effect of GLP-1 therapy. Though, researchers emphasize that this is an association and does not prove causation. Further studies are needed to determine if GLP-1s directly impact breast cancer outcomes.
Disparities in Access to GLP-1 medications
The study also revealed significant disparities in who is receiving GLP-1 medications. Use was higher among:
* White patients
* Telemedicine users
* Patients in rural areas
Conversely,use was lower among:
* Older patients (over 75)
* Patients with advanced-stage disease (stage IV)
* Patients with hormone receptor-negative/HER2-negative (HR-/HER2-) tumors – a more aggressive subtype.
* Latinx and Asian patients
* Individuals with limited English proficiency
* Patients receiving care at community medical centers (compared to academic institutions).
These findings underscore the impact of social determinants of health (SDOH) – the non-medical factors that influence health outcomes – on access to possibly beneficial therapies.
Implications and Future Research
The study highlights the need for further investigation into the potential role of GLP-1 medications in breast cancer care, beyond their established benefits for weight management. Researchers are calling for clinical trials to determine if GLP-1s can improve outcomes such as progression-free survival and overall survival in breast cancer patients.
Crucially, addressing the identified disparities in access is paramount. Strategies to improve equitable access could include:
* Increased awareness among healthcare providers about the potential benefits of GLP-1s in breast cancer.
* Culturally tailored education materials for patients with limited English proficiency.
* Telemedicine expansion to reach patients in rural areas.
* Addressing systemic barriers to care within community medical centers.
Reference:
Ryals CA et al. Real-world glucagon-like peptide 1 use and association with clinical characteristics, social determinants, and circulating tumor DNA positivity in patients with breast cancer. Abstract PD8-07-02. SABCS 2025; 9-12 December.
Key Takeaways:
* GLP-1 medications may be associated with reduced circulating tumor DNA in breast cancer patients, suggesting a potential anti-cancer effect.
* Significant disparities exist in access to GLP-1s based on race, ethnicity, age, disease stage, and healthcare setting.
* Further research is needed to confirm the clinical benefits of GLP-1s in breast cancer and to address inequities in access.
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