(UroToday.com) The 2026 American Society of Clinical Oncology Genitourinary (ASCO) Annual Meeting, held in Chicago, IL, will host the Kidney and Bladder Cancer - Posters Session. Dr. Benyamin Yaniv will present Abstract 4620: Association of GLP-1 receptor agonist therapy with BCG response in high-risk NMIBC.
Emerging evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1RAs) may be associated with reduced cancer incidence and improved oncologic outcomes across multiple malignancies.1 Observational studies in lung cancer have additionally suggested improved responses to immune checkpoint inhibitors among patients receiving GLP-1RAs, raising the possibility that these agents may enhance anti-tumor immunity.1 Given that intravesical BCG remains the cornerstone treatment for high-risk NMIBC, they evaluated whether GLP-1RA exposure during BCG therapy was associated with improved clinical outcomes in patients with HR-NMIBC.
Using the TriNetX US Research Network, investigators retrospectively evaluated patients with HR-NMIBC treated between November 2015 and November 2025. Patients were stratified according to GLP-1RA exposure prior to BCG initiation, including those with overlapping exposure during BCG treatment, versus no GLP-1RA exposure. Cohorts were propensity score matched for demographics and comorbidities. The primary endpoint was mortality, while secondary endpoints included recurrence, progression to MIBC, radical cystectomy, and distant metastasis.
A total of 12,423 patients were included, of whom 791 (7%) received GLP-1RAs, and 11,630 (93%) did not. After propensity score matching, 787 patients remained in each cohort. Mean age was 73 years, with most patients being White (85%), male (80%), and non-Hispanic (85%). Semaglutide was the most commonly used GLP-1RA (67%), followed by dulaglutide (37%), tirzepatide (21%), liraglutide (17%), exenatide (8%), and lixisenatide (1%).
Patients exposed to GLP-1RAs demonstrated a significant reduction in 10-year mortality (RR 0.65; 95% CI 0.45–0.93; p=0.017) and a significantly lower risk of progression to MIBC (RR 0.43; 95% CI 0.26–0.89; p=0.018). However, no statistically significant differences were observed in NMIBC recurrence (RR 0.98; p=0.84), radical cystectomy (RR 0.94; p=0.65), or distant metastasis (RR 0.83; p=0.19).
Take home messages:
- GLP-1RA exposure prior to and during BCG therapy was associated with significantly lower all-cause mortality in patients with HR-NMIBC
- Patients receiving GLP-1RAs were significantly less likely to progress to MIBC
- No significant differences were observed in recurrence, radical cystectomy, or distant metastasis rates
- These findings support the hypothesis that GLP-1RAs may modulate anti-tumor immunity and potentially enhance outcomes in patients receiving BCG
- Prospective studies are warranted to further evaluate the role of GLP-1RAs in NMIBC management
Presented by: Benyamin Yaniv, MD, Resident at University of Massachusetts Chan Medical School. United States
Written by: Julian Chavarriaga, MD, Clinical Assistant Professor, Urologic Oncologist, Department of Urology at Penn State Health @chavarriagaj on X during the American Society of Clinical Oncology Genitourinary (ASCO) Annual Meeting held in Chicago, IL between May 29th and June 1st, 2026
References:- Pachimatla AG, Fitzgerald B, Ogidigo J, Bhatia M, Smith RJ Jr, Ratnakaram K, Kalvapudi S, Vedire Y, Washington D, Vethanayagam Rr R, Hsiao HH, Rosario S, Sanghvi VR, Barbi J, Yendamuri S. Glucagon-like peptide-1 receptor agonism improves lung cancer outcomes and tumor growth control. JCI Insight. 2025 Aug 26;10(19):e195484. doi: 10.1172/jci.insight.195484. PMID: 40857107; PMCID: PMC12513478.