“Semaglutide and Cancer: A Systematic Review and Meta-Analysis”, 2023-09 ():
Data from 37 studies having 46,719 patients were analysed.
- Pancreatic cancer was not increased with semaglutide [OR 0.25 (95% CI: 0.03–2.24); p = 0.21].
- Thyroid cancer was not increased with semaglutide [OR 2.04 (95% CI: 0.33–12.61); p = 0.44].
All neoplasms were not increased with semaglutide [OR 0.95 (95% CI:0.62–1.45); p = 0.82]
Background: The French national health care insurance system database has suggested 1–3 years use of glucagon like peptide-1 receptor agonists (GLP1RA) (exenatide, liraglutide and dulaglutide) may be linked with increased occurrence of thyroid cancer. Similar data on semaglutide is unavailable. Hence, we undertook this systematic review to look at the safety of semaglutide focusing on different cancers.
Method: Databases were searched for randomized controlled trials (RCTs) and real-world studies involving patients receiving semaglutide in the intervention-arm. Primary outcome was to evaluate the occurrence of pancreatic and thyroid cancers. Secondary outcomes were to evaluate occurrence of any other malignancies or severe adverse-events.
Results: Data from 37 RCTs and 19 real-world studies having 16,839 patients in placebo-control group, 16,550 patients in active-control group and 13,330 patients in real-world studies were analysed. Compared to placebo, occurrence of pancreatic cancer [OR 0.25 (95% CI: 0.03–2.24); p = 0.21], thyroid cancer [OR 2.04 (95% CI: 0.33–12.61); p = 0.44; I2 = 0%] and all neoplasms (benign, malignant and otherwise unspecified) [OR 0.95 (95% CI: 0.62–1.45); p = 0.82; I2 = 0%] was similar in the semaglutide group. Compared to active controls, occurrence of pancreatic cancer [OR 0.40 (95% CI: 0.09–1.87); p = 0.26; I2 = 0%], thyroid cancer [OR 1.19 (95% CI: 0.15–9.66); p = 0.87; I2 = 0%] and all neoplasms (benign, malignant and otherwise unspecified) [OR 0.91 (95% CI: 0.44–1.89); p = 0.79; I2 = 0%] were similar in the semaglutide group. Real-world data analysis revealed a single case each of pancreatic cancer and B-cell lymphoma.
Conclusion: Semaglutide use in RCTs and real-world studies was not associated with an increased risk of any types of cancer, and this conclusion is supported by a high grade of evidence.
[Keywords: semaglutide, cancer, thyroid cancer, pancreatic cancer, systematic review]