{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T01:38:24Z","timestamp":1792460304331,"version":"4.5.0"},"reference-count":49,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Patients with breast cancer (BC) with comorbid obesity or type 2 diabetes (T2D) experience poorer survival. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are approved to treat these comorbidities; however, their associations with BC survival and recurrence remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the association between GLP-1 RA use and 10-year all-cause mortality and recurrence-free survival (RFS) over the 10-year follow-up period, as well as 5- and 10-year all-cause mortality and RFS probabilities among patients with BC.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort study used TriNetX US Collaborative Network data from women (\u226518 years) with BC from 68 health care organizations who received a diagnosis between April 1, 2006, and April 1, 2023. Propensity score matching balanced characteristics. Data were analyzed between September 16 and October 3, 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n GLP-1 RA use (\u22652 prescriptions) during the 6 months before and any time after the index diagnosis; nonuse (0 entries).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was all-cause mortality, and the secondary outcome was RFS. Cox proportional hazards regression model\u2013estimated hazard ratios (HRs) were restricted to 10 years. Kaplan-Meier estimators were used to calculate 5- and 10-year all-cause mortality and RFS probabilities. Prespecified subgroup (postmenopausal) and landmark (6- and 12-month) analyses were conducted.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study comprised 841\u202f831 eligible patients with BC (mean [SD] age, 69.1 [12.2] years). After exclusions and 1:1 propensity score matching, 3 cohorts were identified: 1610 patients for GLP-1 RA use vs nonuse (patients with obesity [body mass index \u226530]), 2323 patients for GLP-1 RA use vs insulin or metformin (patients with T2D), and 4052 patients for GLP-1 RA use vs sodium-glucose cotransporter 2 inhibitors (patients with T2D). Among patients with obesity, GLP-1 RAs were associated with lower hazard of all-cause mortality (HR, 0.35; 95% CI, 0.21-0.58;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and RFS (HR, 0.44; 95% CI, 0.30-0.64;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) over a 10-year follow-up period. Among patients with T2D, GLP-1 RAs vs insulin or metformin were associated with lower hazard of all-cause mortality (HR, 0.09; 95% CI, 0.06-0.15;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and RFS (HR, 0.33; 95% CI, 0.21-0.50;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). No significant differences were observed between GLP-1 RA and sodium-glucose cotransporter 2 inhibitor groups. Subgroup and landmark analyses yielded similar findings.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of patients with BC, findings suggested a potential association between GLP-1 RA use and improved outcomes among patients with BC who have obesity and related metabolic conditions. These findings support further evaluation of GLP-1 RA therapy in randomized clinical trials.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.12133","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T15:30:36Z","timestamp":1778513436000},"page":"e2612133","source":"Crossref","is-referenced-by-count":17,"title":["Survival and Recurrence With GLP-1 Receptor Agonists in Breast Cancer"],"prefix":"10.1001","volume":"9","author":[{"given":"Kristina L.","family":"Tatum","sequence":"first","affiliation":[{"name":"Department of Social and Behavioral Sciences, School of Public Health, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassam","family":"Dahman","sequence":"additional","affiliation":[{"name":"Department of Health Policy, School of Public Health, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniyah","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Virginia State University, Petersburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Williford","sequence":"additional","affiliation":[{"name":"TriNetX LCC, Cambridge, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Brian","family":"Cassel","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine, School of Medicine, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kandace P.","family":"McGuire","sequence":"additional","affiliation":[{"name":"Department of Surgery, School of Medicine, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obinna","family":"Diala","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Racheal","family":"Oladimeji","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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