{"entity":{"id":"idea-prev-glp1-cancer-prevention-rct","kind":"idea","name":"A trial of GLP-1 weight-loss drugs with cancer as the primary outcome","aka":[],"tldr":"Obesity raises the risk of 13 cancers, and GLP-1 weight-loss drugs are already in routine use for diabetes and obesity. Observational data hint that they cut obesity-related cancers but confounding is severe, so a randomised trial in adults aged 50 to 70 with a BMI of 30 or more should make cancer the primary outcome.","summary":"Observational data suggest GLP-1 receptor agonists reduce obesity-related cancer incidence, but confounding is severe. Propose an RCT, or prospective cancer adjudication embedded in ongoing cardiovascular outcome trials, with incident obesity-related cancer as the primary endpoint in adults aged 50-70 with BMI of 30 or more.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Prevention we already have is not deployed): Islami et al., Proportion of cancer attributable to modifiable risk factors (CA 2018)","url":"https://doi.org/10.3322/caac.21440"}],"tags":[],"related":[],"cancers":["endometrial","colorectal","pancreatic","hcc"],"sections":["prevention"],"technologies":["chemoprevention"],"targets":[],"drugs":[],"companies":["eli-lilly"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-prevention-adoption"],"keyPapers":["paper-islami-ca-cancer-j-clin"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"GLP-1 receptor agonist therapy reduces incidence of obesity-related cancers by at least 20% over seven years.","rationale":"Bariatric surgery reduces cancer incidence in cohort studies; pharmacological weight loss may reproduce this through insulin/IGF and inflammatory pathways.","test":"Run a 20,000-person RCT or a pooled analysis of cardiovascular outcome trials with prospective cancer adjudication.","maturity":"early-clinical","actor":"industry","cost":"large","horizonYears":8},"route":"/ideas/idea-prev-glp1-cancer-prevention-rct/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"endometrial","kind":"cancer","name":"Endometrial cancer","route":"/cancers/endometrial/"},{"id":"hcc","kind":"cancer","name":"Hepatocellular carcinoma","route":"/cancers/hcc/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"technology":[{"id":"chemoprevention","kind":"technology","name":"Chemoprevention & risk-reducing surgery","route":"/technologies/chemoprevention/"},{"id":"glp1-agonists-cancer-risk","kind":"technology","name":"GLP-1 receptor agonists and obesity-related cancer risk","route":"/technologies/glp1-agonists-cancer-risk/"}],"company":[{"id":"eli-lilly","kind":"company","name":"Eli Lilly (incl. Loxo)","route":"/companies/eli-lilly/"}],"bottleneck":[{"id":"b-prevention-adoption","kind":"bottleneck","name":"Prevention we already have is not deployed","route":"/bottlenecks/b-prevention-adoption/"}],"paper":[{"id":"paper-body-fatness-iarc-nejm-2016","kind":"paper","name":"IARC verdict: excess body fat causes 13 cancers","route":"/key-papers/paper-body-fatness-iarc-nejm-2016/"},{"id":"paper-islami-ca-cancer-j-clin","kind":"paper","name":"Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States","route":"/key-papers/paper-islami-ca-cancer-j-clin/"}],"idea":[{"id":"idea-nl-glp1-adjuvant-hr-breast","kind":"idea","name":"GLP-1 receptor agonists as adjuvant weight-loss therapy in HR-positive breast cancer","route":"/ideas/idea-nl-glp1-adjuvant-hr-breast/"},{"id":"idea-nl-bariatric-cancer-registry-linkage","kind":"idea","name":"Link bariatric and GLP-1 registries to cancer registries in every country that has both","route":"/ideas/idea-nl-bariatric-cancer-registry-linkage/"}],"roadmap":[{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"},{"id":"nutrition-lifestyle-roadmap","kind":"roadmap","name":"Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment","route":"/roadmaps/nutrition-lifestyle-roadmap/"}]}}