11181 Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used in cancer survivors with Type 2 Diabetes (T2D) given its efficacy, yet concerns regarding treatment tolerance, weight loss, and limited oncology-specific guidance during active treatment and survivorship may influence prescribing patterns. To date, little evidence exists regarding the trends and factors associated with GLP-1RA use in cancer populations with T2D. Methods: We conducted a retrospective cohort study using SEER–Medicare data to identify patients newly diagnosed with seven most common cancers in 2010-2021 with pre-existing T2D. Pre-existing T2D was defined by relevant diagnosis codes within 12 months prior to cancer diagnosis. Patients with continuous Medicare Parts A similarly higher GLP-1RA use was observed in cancer than non-cancer cohort among MA beneficiaries in 2016-2021 (1.8% to 6.8% vs. 1.3% to 5.7%; unadjusted p-values < 0.001). Rapid uptake was observed for dulaglutide and semaglutide from 2015, while liraglutide use declined modestly after peaking in 2018. In adjusted analyses within the cancer cohort, patients with breast (0.87 percentage points ppts, p < 0.001), female genital (1.08 ppts, p < 0.001), and prostate cancers (0.62 ppts, p = 0.001) were more likely to receive GLP-1RAs than those with colorectal cancer. More advanced cancer stage was associated with lower likelihoods of GLP-1RA use; Non-Hispanic White, higher socioeconomic neighborhoods, and dual eligibility were associated with higher likelihoods of GLP-1RAs use. Conclusions: GLP-1RA use increased substantially among Medicare beneficiaries with cancer and T2D, and was consistently higher than those without cancer, which may reflect greater clinical engagement and cardiometabolic risk burden following a cancer diagnosis. Variation by cancer site, stage, and socioeconomic factors suggest that both clinical complexity and structural determinants shape GLP-1RA use in cancer survivors.
Graetz et al. (Wed,) studied this question.