The association of GLP-1 receptor agonist use with survival and immune-related adverse events in patients receiving immune checkpoint inhibitors: A multi-institutional real-world analysis.

11000 Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed in patients with cancer for metabolic comorbidities and weight management. However, their impact on outcomes in patients receiving immune checkpoint inhibitors (ICIs) remains poorly characterized. We evaluated the association between concurrent GLP-1 RA use and survival and immune-related adverse events (irAEs) in a large real-world oncology population. Methods: We conducted a federated electronic health record–based cohort study using the TriNetX Research Network (113 healthcare organizations). Adult patients with solid and hematologic malignancies treated with PD-1/PD-L1 or CTLA-4 inhibitors were identified. Patients were stratified by exposure to GLP-1 RAs. Propensity score matching was performed to balance demographics, comorbidities, and baseline clinical characteristics. Kaplan–Meier survival analyses and Cox proportional hazards models were used to compare overall survival at 3 and 5 years. Incidence of irAEs, including neutropenia and pyrexia, was assessed using risk and odds ratios. Results: A total of 3,807 patients receiving ICIs with concurrent GLP-1 RAs were matched to 173,423 patients receiving ICIs without GLP-1 RAs. At 3 years, GLP-1 RA exposure was associated with improved survival (hazard ratio [HR] 0.69, 95% CI 0.64–0.75; log-rank p