Should we exclude hemato-oncological patients from obesity treatment with semaglutide? – A case report

• Authors: Julia Dobrowolska , Katarzyna Kozak , Agnieszka Morawa , Laura Peisert , Kamil Wdowiak , Jerzy Chudek

Title variants

PL

Czy powinniśmy wykluczyć pacjentów hematoonkologicznych z leczenia otyłości semaglutydem? – opis przypadku

• Languages of publication: EN PL

Abstracts

EN

Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), is now widely used in the treatment of diabetes and obesity. However, there are still insufficient safety data for the use of GLP-1RAs in oncological and hemato-oncological patients, as they have not been included in clinical trials. The potential prooncogenic activity of GLP-1RAs in patients with thyroid cancer has been reported, raising concerns about the safety of semaglutide in oncological and hemato-oncological patients. We present a case of a 57-year-old man, who suffered from class III obesity (BMI: 40.4 kg/m2), type 2 diabetes, and chronic lymphocytic leukemia (CLL; RAI stage I and Binet A stage). The patient started therapy with semaglutide to manage obesity and diabetes; he had already begun systemic therapy for CLL with obinutuzumab and venetoclax, which was continued after its complete remission. More than 3 years of semaglutide therapy improved the patients’ metabolic control of diabetes and resulted in significant weight loss (16% of the initial body mass), with no reported adverse drug reactions and without compromising hematologic stability. Our case report suggests that hemato-oncological patients should not be categorically excluded from treatment with semaglutide, as long as close hematological and clinical monitoring is ensured. However, as this observation is based on a single case report, no definitive general recommendations regarding the safety of semaglutide in hemato-oncological patients can be made at this time.

PL

Semaglutyd, będący agonistą receptora glukagonopodobnego peptydu 1 (glucagon-like peptide-1 receptor agonist – GLP-1RA), znajduje szerokie zastosowanie w terapii cukrzycy oraz leczeniu otyłości. Mimo to wciąż brakuje wystarczających danych dotyczących stosowania GLP-1RAs u pacjentów onkologicznych i hematoonkologicznych, ponieważ nie zostali oni uwzględnieni w badaniach klinicznych. Pojawiające się doniesienia o korelacji stosowania GLP-1RAs i nowotworzenia, szczególnie w przypadku nowotworów tarczycy, zrodziło dalsze obawy co do bezpieczeństwa stosowania semaglutydu u pacjentów onkologicznych i hematoonkologicznych. W pracy przedstawiono przypadek 57-letniego pacjenta, chorującego na otyłość III stopnia (BMI: 40,4 kg/m2), cukrzycę typu 2 oraz przewlekłą białaczkę limfocytową (chronic lymphocytic leukemia – CLL; RAI I, Binet A). W celu leczenie otyłości i cukrzycy pacjent rozpoczął terapię semaglutydem, następnie włączono leczenie systemowe CLL obejmujące obinutuzumab z wenetoklaksem; po uzyskaniu remisji CLL kontynuowano leczenie semaglutydem. Ponad 3-letnia terapia semaglutydem pozwoliła na optymalną kontrolę glikemii i spowodowała istotną utratę masy ciała (16% wyjściowej masy ciała pacjenta), podczas leczenia nie odnotowano żadnych działań niepożądanych ani negatywnego wpływu na parametry hematologiczne oraz uzyskaną remisję. Opisany przypadek sugeruje, że pacjentów hematoonkologicznych nie należy kategorycznie wykluczać z leczenia semaglutydem, pod warunkiem zapewnienia właściwego monitorowania parametrów hematologicznych oraz stanu klinicznego. Ponieważ jednak obserwacja opiera się na pojedynczym opisie przypadku, nie można obecnie sformułować jednoznacznych, ogólnych zaleceń dotyczących bezpieczeństwa stosowania semaglutydu w tej grupie pacjentów.

Keywords

EN

cancer; case report; cukrzyca typu 2; nowotwór; obesity; oncogenesis; onkogeneza; opis przypadku; otyłość; semaglutide; semaglutyd; type 2 diabetes

Discipline

• MEDICINE: MEDICINE

• Publisher: Śląski Uniwersytet Medyczny w Katowicach
• Journal: Annales Academiae Medicae Silesiensis
• Year: 2025
• Volume: 79
• Pages: 316–322

Contributors

author

Julia Dobrowolska

• Students’ Scientific Club, Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

author

Katarzyna Kozak

• Students’ Scientific Club, Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

author

Agnieszka Morawa

• Students’ Scientific Club, Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

author

Laura Peisert

• Students’ Scientific Club, Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

author

Kamil Wdowiak

• Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

author

Jerzy Chudek

• Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

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• Document Type: article