TOPLINE: 

In patients with overweight or obesity, weight reduction achieved with most antiobesity medications — besides coagonists — is not linked with a significantly reduced risk for overall or site-specific obesity-associated cancers.

METHODOLOGY:

• Obesity is an independent risk factor for multiple types of cancer, but whether weight loss achieved through antiobesity medications lowers this risk remains uncertain.
• Researchers conducted a meta-analysis of randomized controlled trials of antiobesity medications reporting obesity-associated cancer outcomes in patients with overweight or obesity.
• Predefined obesity-associated cancers included esophageal, breast, colorectal, endometrial, stomach, kidney, hepatocellular, ovarian, pancreatic, and thyroid cancers, as well as meningioma and multiple myeloma.

TAKEAWAY:

• Researchers identified 25 eligible studies (mean follow-up, 65.2 weeks) involving 40,731 patients, of which 23,877 received antiobesity medications and 16,854 received placebo.
• Studies evaluated GLP-1 receptor agonists semaglutide (n = 13), the GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) co-agonist tirzepatide (n = 4), the GLP-1/glucagon receptor co-agonist cotadutide (n = 1), the amylin/calcitonin receptor co-agonist cagrilintide (n = 1), the GLP-1/GIP/glucagon/triagonist retatrutide (n = 1), phentermine-topiramate (n = 2), and naltrexone-bupropion (n = 3).
• Compared with placebo, antiobesity medications were not significantly associated with a lower risk for overall obesity-associated cancer (relative risk [RR], 1.03) or site-specific cancers.
• A 5-kg weight reduction mediated by antiobesity medications was not associated with decreased risk for overall or site-specific obesity-associated cancer.
• Unlike other medications assessed, use of coagonists (tirzepatide, cotadutide, or cagrilintide) was significantly associated with a reduced risk for overall obesity-associated cancer (RR, 0.43).
• Patients who lost approximately 5 kg on coagonist drugs showed a marginally significant reduction in overall cancer risk (RR, 0.79).

IN PRACTICE:

"Coagonists…target dual receptors to enhance weight loss and metabolic regulation. Our study suggested that their dual-receptor targeting mechanism might confer additional benefits for cancer prevention," the authors wrote

SOURCE:

This study was conducted by Chengwen Li et al, Peking University People's Hospital, Beijing, and published online in Obesity.

LIMITATIONS: 

The meta-analysis included trials with relatively short follow-up periods, limiting detection of long-term cancer outcomes. It did not compare antiobesity medications with bariatric surgery or intensive lifestyle interventions. Baseline data on key cancer risk factors (family history, genetics, and comorbidities) were incomplete.

DISCLOSURES:

The study received funding from the Noncommunicable Chronic Diseases-National Science and Technology Major Project, the 2024 National Clinical Key Specialty Construction Program of China, and other sources. One author reported receiving lecture and consulting fees from various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.