Neeraj Agarwal: Hi. My name is Dr. Neeraj Agarwal. I'm a Professor of Medicine and director of Genitourinary Oncology Program at the Huntsman Cancer Institute, University of Utah in Salt Lake City. Today, I'm so pleased to welcome Dr. Amy Shaver from the Thomas Jefferson University Hospital.

Dr. Shaver, first of all, congratulations on your presentation at the ASCO 2025 meeting on the association or impact or the effect of GIP and GLP-1 inhibitors in patients with prostate cancer. We personally thought the whole field of study was quite exciting. So first of all, thank you for being here.

Amy Shaver: Thank you for having me.

Neeraj Agarwal: So what made you think about doing this study with this new class of agents, which is already in news so much?

Amy Shaver: So a lot of my research revolves around looking at comorbidity management within the realm of active cancer treatment. And in particular, people who have dysfunctional metabolisms. So in prostate cancer, your backbone of treatment is ADT, which can lead men if they're not already overweight or obese or have issues with cardiovascular problems, it's going to lead there or have a high risk of leading there.

So in looking at patients with CVD risk and type 2 diabetes, these GLP-1s are just exploding in the general population. So I wanted to see are there enough men, at least nationally, to study who have prostate cancer and are concurrently on GLP-1 agonists GIP agonists to see what happens to them. So this study was really just to look at a trend of use. Is it mirroring what we're seeing in the general population?

Neeraj Agarwal: And just for our audience, could you please elaborate the name of some of the drugs you looked at?

Amy Shaver: The GLP-1 agonists are like semaglutide, liraglutide—the glutides. So that's the great thing in pharmacy. You have endings that are similar. And then you have the GLP-1 GIP, which is tirzepatide. And those drugs are essentially incretin analogs. They'll decrease or slow gastric emptying, they'll increase insulin secretion.

And so for the type 2 diabetics, that's a great thing. You have these drugs and they're helping your body do what it would like to do. And they seem to be a step up from the DPP-4 inhibitors. Those drugs were used to stop the enzyme that would normally break down GLP and GIP in the body.

Neeraj Agarwal: So both classes of drugs look like can have profound effect on the metabolic pathways in various ways.

Amy Shaver: Yes.

Neeraj Agarwal: And that's why they are affecting-- somehow they may have effect on the cancer progression prognosis and many other aspects.

Amy Shaver: That's what we're hoping. There's been some studies indicating that the GLP receptor is found in prostatic tissue regardless of stage. There was an interesting study recently showing that it was found distinctly in metastatic prostate cancer. So next steps for me now that I know that we have these users of GLP, GIP receptor agonists among prostate patients, is to see in these people is there a slower progression of cancer?

Do we see in metastatic patients who are hormone-sensitive? Do they have more time before becoming castration-resistant? And that will be next steps from this, because I know I have the numbers.

Neeraj Agarwal: So how many patients you had in your database and how many of them were on this class of drug?

Amy Shaver: It was nearly 2 million patients across all stages of prostate cancer. And on this class of drug, we're looking at only about 6% of patients. But that's what you see in the general population. So that was really encouraging. What I did find interesting is over time, when you first had these drugs approved in 2015 through the end of 2024, there was an increase in the use and by 2024, what we are seeing is people being prescribed these medications who don't have the indication for it.

So they're not obese. They didn't have type 2 diabetes, but they did have prostate cancer. So it's definitely something we have to look into because people are going to use these medications and you have people going to spas and getting these medications. And my database isn't tracking that, but we know it's there.

Neeraj Agarwal: Yes. That is a humongous database to look at—two million patients with prostate cancer, 6% of them are on GLP or GIP inhibitors. And we look forward to more results and data from you in the future meetings on how these inhibitors are affecting the course of prostate cancer down the line. And if somebody would like to collaborate with you, how would you like them to contact you?

Amy Shaver: Oh, via email at it's . So I'd love to collaborate with somebody looking at cancer progression and these medications.

Neeraj Agarwal: Well thank you Dr. Shaver for taking the time. And congratulations on your presentation.

Amy Shaver: Thank you for having me.