Effects of Glucagon-Like Peptide-1 Receptor Agonists on Upper Gastrointestinal Adverse Events in Patients Receiving Platinum Analog-Based Chemotherapy.

Abstract

Objectives: Many patients with cancer receive chemotherapy alongside glucagon-like peptide-1 receptor agonists (GLP-1 RA) to manage type 2 diabetes or obesity. However, both GLP-1 RA and platinum-based chemotherapies can cause upper gastrointestinal (GI) adverse effects (AE) such as nausea and vomiting. This study aimed to evaluate the impact of GLP-1 RA use in patients receiving platinum-based chemotherapy, focusing on GI AE incidence, risk factors, and treatment outcomes.

Methods: This single-center study retrospectively reviewed patients who were treated with a platinum-based therapy and concurrent GLP-1 RA and developed symptoms of upper GI AE.

Results: The study included 200 patients. Upper GI adverse events occurred in 126 patients. Compared with patients without GI AE, patients with GI AE received fewer doses of platinum therapy (median: 2.5 vs. 5, P<0.0001) and had higher all-cause mortality (40.5% vs. 25.7%, P=0.034), shorter follow-up (median: 1.5 vs. 2.7 y, P<0.0001), and a higher rate of hypothyroidism (35.1% vs. 20.6%, P=0.025). GI AEs were treated with 5-HT3 receptor antagonists in 123 (99.2%) patients and corticosteroids in 5 (4.0%). GI AE symptoms lasted a median of 42.5 days; 92.7% achieved clinical remission of GI AE. Twenty-one (16.7%) patients required hospitalization for GI AE, of whom 4 required rehospitalization. Platinum analogs were discontinued in 72 (57.1%) patients and resumed in 57 (79.2%). GLP-1 RA was discontinued in 11 (8.7%) patients.

Conclusions: Most patients receiving GLP-1 RA and platinum-based chemotherapy developed mild GI AE that responded to conservative management.