DOI: 10.1097/coc.0000000000001358 ISSN: 0277-3732

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

Varun Vemulapalli, Carolina C. Cruz, Maria J.M.N. Santos, Rachel Mortan, Nina Quirk, Humberto R. Nieves Jimenez, Andrew Sullivan, Anirudha Chatterjee, Jacob Reitnauer, Cristina Natha, Anusha Thomas, Lavanya Viswanathan, Van K. Morris, David Richards, Karen C. Kim, Yinghong Wang
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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.

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