Practical considerations for the use of incretin mimetics in patients with neuroendocrine neoplasms: An expert consensus statement

Udhayvir S Grewal; Po H Ear; Mohamad B Sonbol; Andrew M Bellizzi; Johannes Hofland; Joakim Crona; Joseph S Dillon; Jennifer A Chan; James R Howe; Jonathan Strosberg; Simron Singh; Thorvardur R Halfdanarson

doi:10.1002/cncr.70586

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Practical considerations for the use of incretin mimetics in patients with neuroendocrine neoplasms: An expert consensus statement

Journal article

Peer reviewed

Practical considerations for the use of incretin mimetics in patients with neuroendocrine neoplasms: An expert consensus statement

Udhayvir S Grewal, Po H Ear, Mohamad B Sonbol, Andrew M Bellizzi, Johannes Hofland, Joakim Crona, Joseph S Dillon, Jennifer A Chan, James R Howe, Jonathan Strosberg, …

Cancer, Vol.132(16), e70586

08/15/2026

DOI: 10.1002/cncr.70586

PMID: 42606162

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Abstract

Incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1RA) and dual incretin agonists, are increasingly used for the management of diabetes, obesity, and cardiometabolic disease. Although their systemic benefits are well established, uncertainty remains regarding their safety in patients with neuroendocrine neoplasms (NENs), a biologically heterogeneous group of tumors with diverse molecular profiles. Preclinical studies suggest that GLP-1 receptor activation may promote tumor growth in select receptor-expressing models, although receptor expression varies widely across NEN subtypes and is often absent in common tumors such as ileal neuroendocrine tumors. Population-level and retrospective clinical data have not demonstrated a consistent increase in oncologic risk but are limited by methodological constraints. In this expert consensus statement, the authors synthesize current evidence and provide a practical framework for the use of incretin mimetics in patients with NENs. The authors emphasize individualized risk assessment, shared decision-making, and multi-disciplinary collaboration, balancing potential but unquantified oncologic risks against substantial cardiometabolic benefits. Until prospective data are available, careful patient selection, dose optimization, and close clinical and radiologic surveillance remain essential to guide safe and effective use of these agents in this population.

Consensus

Glucagon-Like Peptide-1 Receptor - metabolism

Glucagon-Like Peptide-1 Receptor Agonists

Humans

Incretins - therapeutic use

Neuroendocrine Tumors - drug therapy

Neuroendocrine Tumors - metabolism

Risk Assessment

Details

Title: Subtitle: Practical considerations for the use of incretin mimetics in patients with neuroendocrine neoplasms: An expert consensus statement
Creators: Udhayvir S Grewal - Emory University
Po H Ear - Emory University
Mohamad B Sonbol - Mayo Clinic in Arizona
Andrew M Bellizzi - Columbia University
Johannes Hofland - Erasmus MC Cancer Institute
Joakim Crona - Uppsala University
Joseph S Dillon - University of Iowa
Jennifer A Chan - Dana-Farber Cancer Institute
James R Howe - University of Iowa
Jonathan Strosberg - Moffitt Cancer Center
Simron Singh - Sunnybrook Health Science Centre
Thorvardur R Halfdanarson - Mayo Clinic
Resource Type: Journal article
Publication Details: Cancer, Vol.132(16), e70586
DOI: 10.1002/cncr.70586
PMID: 42606162
NLM abbreviation: Cancer
ISSN: 0008-543X
eISSN: 1097-0142
Publisher: Wiley
Language: English
Date published: 08/15/2026
Academic Unit: Pathology; Surgery; Fraternal Order of Eagles Diabetes Research Center; Endocrinology and Metabolism; Internal Medicine
Record Identifier: 9985219326902771

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