A large real-world study found that patients with cancer who used GLP-1 receptor agonists alongside immunotherapy had significantly better long-term survival and fewer immune-related side effects.
Patients with cancer who were taking a GLP-1 receptor agonist (GLP-1 RA) — a class of medications commonly used for type 2 diabetes and weight loss — at the same time as immune checkpoint inhibitor (ICI) therapy showed significantly better long-term survival and fewer immune-related side effects, according to a new real-world study presented at the 2026 ASCO Annual Meeting.
"The protective trends were consistent across all follow-ups of 3 years and 5 years, and these findings suggest a potential synergy or protective effect of GLP-1s on immunotherapy settings," said Dr. Salman Jajja, of New York Medical College, Landmark Medical Center, in Woonsocket, Rhode Island, during the presentation.
How GLP-1 Drugs May Boost Immunotherapy
- GLP-1 receptor agonists, including drugs like Ozempic and Victoza, are thought to carry anti-inflammatory properties that may work together with immunotherapy to improve outcomes.
- Patients with cancer who used GLP-1 receptor agonists alongside immunotherapy were 31% less likely to die over a 5-year follow-up period compared with those who did not use GLP-1 drugs.
- The survival benefit was seen at both 3 and 5 years of follow-up, suggesting the protective effect grows stronger with longer exposure to the combination.
- GLP-1 users experienced lower rates of immune-related side effects such as fever, fatigue, sepsis, cachexia (extreme weight loss), and pneumonia.
- Researchers plan to conduct a prospective clinical study to better understand how this combination works and what it means for cancer treatment decisions.
What effect do GLP-1s have on patients who are also receiving immunotherapy?
In a matched analysis of more than 3,400 patients per group, GLP-1 RA users had a 31% lower risk of death over 5 years compared with patients who did not take a GLP-1 drug alongside their immunotherapy. In concrete numbers, 5-year all-cause mortality was 32% among GLP-1 RA users, compared with 45% among those not taking a GLP-1 medication — a 13 percentage-point difference.
At the 3-year mark, GLP-1 RA use was associated with a similar survival advantage, with users having a 31% lower risk of death. Notably, no statistically significant survival benefit was detected at 1 year, which the researchers said suggests the protective effect may build over time with continued exposure.
GLP-1 RA use was also tied to lower rates of immune-related side effects, caused by the immune system becoming overactive as a result of immunotherapy treatment. Patients taking GLP-1 drugs showed significantly lower rates of fever (pyrexia) at 3 years, with a 2.5 percentage-point risk reduction, and similar protective trends at 5 years.
Rates of fatigue and malaise (25% vs. 29%, respectively), sepsis (15% vs. 18%), extreme weight loss known as cachexia (4% vs. 5%), and pneumonia (14% vs. 18%) were all lower in the GLP-1 group, though some differences in individual measures such as low white blood cell counts (neutropenia) did not reach statistical significance.
What is next for GLP-1 use in cancer care?
The study drew on the TriNetX Research Network, a federated database of electronic health records spanning 113 healthcare organizations. Researchers identified adult patients with solid tumors and blood cancers who were treated with PD-1, PD-L1, or CTLA-4 inhibitors — common types of checkpoint immunotherapy — and divided them based on whether they were also taking a GLP-1 receptor agonist at the same time.
Out of an initial pool of 177,230 patients receiving ICI therapy, 3,807 were taking a concurrent GLP-1 RA. After propensity score matching on more than 20 characteristics — including demographics, other medical conditions and clinical features — 3,429 matched patients in each group were followed for up to 5 years.
The researchers noted that GLP-1 receptor agonists are increasingly prescribed for metabolic conditions and weight management in people with cancer, yet their potential impact on survival and treatment side effects had not been studied at this scale. Because GLP-1 drugs carry known anti-inflammatory and immune-regulating properties in early laboratory studies, the team wanted to understand whether those properties might affect how patients respond to immunotherapy.
The research team acknowledged that some metabolic and treatment-related factors may not have been fully captured in electronic health record data. They plan to move forward with a prospective study to better understand the biological mechanisms behind this relationship and its clinical implications for patients on checkpoint inhibitor therapy.
Editor's note: This article is for informational purposes only and is not a substitute for professional medical advice, as your own experience will be unique. Use this article to guide discussions with your oncologist. Content was generated with AI, reviewed by a human editor, but not independently verified by a medical professional.
Reference
- The association of GLP-1 receptor agonist use with survival and immune-related adverse events in patients receiving immune checkpoint inhibitors: A multi-institutional real-world analysis. Jajja S, Thukral J, Abdalla A, et al. J Clin Oncol. 2026;
