GLP-1 receptor agonist use during immune checkpoint inhibitor therapy is associated with mortality and Immune-Related adverse events across cancer types in People with type 2 Diabetes: A Target-Trial emulation
Authors' conclusion
GLP-1 RA use during ICI therapy correlated with lower mortality, reduced acute care, fewer irAEs; ophthalmic signals warrant monitoring.
Study context
- Population
- Adults with cancer and T2D starting an immune checkpoint inhibitor (ICI), TriNetX US Collaborative Network2,903 per group
- Participants
- 2,903 vs 2,903
- Exposure
- GLP-1 RA co-exposure at ICI start vs no GLP-1 RA
- GLP-1 RAn = 2,903
- No GLP-1 RAn = 2,903reference
- Outcome
- All-cause mortality
- Follow-up
- 36 months
Methodological detailsnew-user design, 1:1 propensity-score-matched, intention-to-treat, TriNetX US Collaborative Network, Prespecified per-protocol, 90-day landmark and semaglutide-only analyses assessed robustness
- New-user design
- 1:1 propensity-score-matched
- Intention-to-treat
- TriNetX US Collaborative Network
- Prespecified per-protocol, 90-day landmark and semaglutide-only analyses assessed robustness
Main finding
As reported in the abstract
GLP-1 RA vs No GLP-1 RAHazard ratio (95 % CI)
All-cause mortality
0.55(0.51–0.61)
- NNT 5
- absolute risk difference - 16.41 %
Observational data: associations, not effects.
Further findings
Hospitalization (key secondary)
- Hospitalization was lower; HR
- 0.76
- ARD
- - 7.06 %
- NNT
- 11
Composite immune-related adverse events (irAEs) (key secondary)
- Composite irAEs were lower; ARD
- - 7.58 %
- NNT
- 11
Safety
DR progression
- DR progression was higher; HR
- 1.75
- ARD
- + 2.71 %
Non-arteritic anterior ischemic optic neuropathy
- Non-arteritic anterior ischemic optic neuropathy was higher; HR
- 1.51
Hypoglycaemia, acute kidney injury, dehydration/orthostatic hypotension
- Hypoglycaemia, acute kidney injury and dehydration/orthostatic hypotension were lower
Original publication
GLP-1 receptor agonist use during immune checkpoint inhibitor therapy is associated with mortality and Immune-Related adverse events across cancer types in People with type 2 Diabetes: A Target-Trial emulation. Diabetes Res Clin Pract. Published 24 December 2025. doi:10.
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