Today, we’re diving into the fascinating intersection of biopharmaceutical innovation and oncology with Ivan Kairatov, a renowned expert in biopharma with extensive experience in research and development. Ivan’s deep knowledge of technology and innovation in the industry makes him the perfect person to discuss the emerging potential of GLP-1 drugs—originally developed for diabetes and obesity—in the realm of cancer treatment. In this interview, we’ll explore how these versatile medications might impact cancer risk and therapy, the science behind their effects on the body, and the challenges and opportunities that lie ahead in integrating them into oncology.
How did GLP-1 drugs, primarily used for managing diabetes and obesity, come into the conversation for something as complex as cancer treatment?
GLP-1 drugs, like Ozempic and Wegovy, were initially designed to regulate blood sugar and promote weight loss by mimicking a hormone that controls insulin and appetite. Their potential in oncology emerged as researchers noticed their broad effects on various bodily systems. Obesity and diabetes are well-known risk factors for many cancers, and since these drugs tackle those conditions head-on, scientists started exploring whether reducing those risks could also lower cancer incidence. Beyond that, these drugs influence multiple pathways in the body that overlap with cancer development, sparking curiosity about their broader therapeutic potential.
Can you explain one or two key pathways that GLP-1 drugs affect and how those might play a role in preventing or treating cancer?
Certainly. GLP-1 drugs interact with receptors that sit at the top of numerous signaling cascades. One key pathway is the MAP kinase pathway, which is involved in cell growth and division—processes that can go awry in cancer. By modulating this pathway, GLP-1s might help regulate abnormal cell behavior. Another is the NF-kappa B pathway, which plays a role in inflammation and immune response. Since chronic inflammation can fuel cancer progression, influencing this pathway could potentially slow tumor development. These are upstream effects, so the impact is wide-reaching, though we’re still piecing together the exact mechanisms.
Since obesity and diabetes are linked to higher cancer risk, how do GLP-1 drugs help mitigate that risk beyond just promoting weight loss?
Weight loss is a big piece of the puzzle, as excess body fat can drive insulin resistance and inflammation, both of which are tied to cancer risk. GLP-1 drugs help by improving insulin sensitivity and reducing fat mass, which lowers those risk factors. But they also seem to have direct effects on metabolic health, stabilizing blood sugar levels in ways that might reduce stress on cells and prevent the kind of cellular damage that can lead to cancer. It’s a multi-layered impact—weight loss is critical, but the metabolic improvements add another layer of protection.
Certain cancers, like pancreatic and colorectal, are often associated with insulin resistance. Why do you think GLP-1 drugs might be particularly relevant for these specific types?
Insulin resistance creates an environment where cells are constantly exposed to high levels of insulin and glucose, which can stimulate tumor growth. Cancers like pancreatic, endometrial, ovarian, and colorectal are especially sensitive to this because of how metabolic dysfunction drives their development. GLP-1 drugs counteract insulin resistance by enhancing the body’s response to insulin and reducing glucose spikes. By addressing this root issue, they could theoretically lower the chances of these cancers forming or progressing, though we need more targeted studies to confirm the extent of the benefit.
A large study involving 1.6 million people showed lower cancer rates among those using GLP-1 drugs. What makes this finding so noteworthy, and are there any caveats to consider?
That study was a game-changer because of its sheer scale—1.6 million people provide a robust dataset to spot trends. It showed a clear association between GLP-1 use and reduced rates of certain cancers, which is incredibly promising for linking metabolic health to oncology outcomes. However, we have to be cautious. Association doesn’t equal causation, and factors like lifestyle or other treatments weren’t fully controlled for in every case. It’s a strong signal, but we need more controlled clinical trials to understand if GLP-1s are directly responsible for the lower cancer rates.
GLP-1 drugs also seem to influence the immune system, particularly cells like T cells and NK cells. Can you walk us through how these changes might contribute to fighting cancer?
Absolutely. T cells and NK (natural killer) cells are critical players in the immune system’s ability to detect and destroy cancer cells. In obese individuals, these immune cells often don’t function as effectively due to chronic inflammation and metabolic stress. GLP-1 drugs appear to improve the activity of these cells, potentially by reducing inflammation and enhancing their ability to target tumors. It’s like giving the immune system a tune-up, making it more vigilant against cancerous cells, though the precise way this happens is still under investigation.
There’s also talk about GLP-1 drugs helping to overcome chemotherapy resistance. Can you explain what that means for cancer patients and why it’s significant?
Chemotherapy resistance is a major hurdle in cancer treatment—over time, some tumors adapt and stop responding to the drugs meant to kill them. Early research suggests that GLP-1s might interfere with the mechanisms tumors use to resist chemo, possibly by altering metabolic or signaling pathways that cancer cells rely on to survive. If this holds true, it could mean better outcomes for patients, allowing chemo to work more effectively for longer. It’s a big deal, but we’re still in the early stages of understanding how and why this happens.
How do you see GLP-1 drugs potentially enhancing cancer immunotherapies, and what keeps you from being overly optimistic about this right now?
Immunotherapies, which boost the body’s immune response to fight cancer, rely on a healthy and responsive immune system. Since GLP-1s seem to improve immune cell function, especially in metabolically compromised patients, they could amplify the effects of these therapies. For instance, they might make immune checkpoint inhibitors more effective by ensuring immune cells are in top shape to attack tumors. However, I’m cautious because the immune system is incredibly complex, with many overlapping and redundant mechanisms. We need rigorous studies to ensure these combinations are safe and effective before we get too excited.
What’s your perspective on the early concerns about GLP-1 drugs being linked to risks like thyroid or pancreatic cancer, and how confident are we in their safety now?
Those early concerns stemmed from initial studies and case reports suggesting a possible link between GLP-1 drugs and certain cancers, like thyroid or pancreatic. It caused a lot of worry at the time. But more recent, larger-scale studies have not confirmed those risks, which is reassuring. We’re much more confident in their safety profile now, especially with millions of patients using these drugs without a clear signal of increased cancer risk. That said, long-term data is still accumulating, so ongoing monitoring is essential to ensure we’re not missing anything.
Some clinicians are hesitant to use GLP-1 drugs in cancer patients due to side effects like muscle loss or gastrointestinal issues. How serious are these concerns, and how might they affect treatment choices?
These concerns are valid. GLP-1 drugs can cause significant gastrointestinal side effects—nausea, vomiting, and diarrhea—which can be especially tough for cancer patients already dealing with treatment-related discomfort. Muscle loss is another issue, as long-term use might lead to frailty, which is a big risk for patients who need strength to endure cancer therapies. These side effects could influence treatment decisions, requiring doctors to weigh the potential benefits of GLP-1s against the risks of worsening a patient’s condition. Personalized approaches and close monitoring will be key to managing these challenges.
Looking ahead, what is your forecast for the role of GLP-1 drugs in oncology over the next decade?
I’m cautiously optimistic. Over the next ten years, I expect we’ll see GLP-1 drugs being studied more extensively in combination with existing cancer therapies, particularly immunotherapies and chemotherapy. We’re likely to gain clearer insights into which patients and cancer types benefit most from these drugs. There’s a buzz in the research community, and I anticipate major findings being presented at oncology conferences as clinical trials progress. While I don’t see GLP-1s becoming standalone cancer treatments anytime soon, their potential as part of combination strategies could reshape how we approach metabolic and immune factors in cancer care.
