GLP-1 Medications in Oncology Nursing Practice

New drugs and treatments, mechanisms, and toxicity profiles require rapid integration into already complex care environments. Simultaneously, novel findings require vigilance within evidence-based practice. This combination is one of the more challenging aspects of oncology nursing. Because of the holistic nature of cancer care, oncology nurses increasingly manage non-oncologic medications that intersect with cancer care. Glucagon-like peptide-1 receptor agonists (GLP-1RAs, also known as GLP-1s) and glucose-dependent insulinotropic polypeptide agonists (GIPs) are the newest classes to emerge for oncology nursing awareness.

GLP-1s and GIPs mimic gut-derived incretin hormones, released after eating, that stimulate insulin secretion, lower blood sugar, slow stomach emptying, and create satiety sensations (Darwish et al., 2025). The U.S. Food and Drug Administration (FDA) first approved GLP-1s and GIPs for the indication of type 2 diabetes, which has since been extended to obesity/overweight for some drugs in the category. As of May 2026, the United States has the following FDA-approved GLP-1s (with first indication approval year): exenatide (2005); liraglutide (2010); dulaglutide (2014); lixisenatide (2016); liraglutide plus insulin degludec (2016); lixisenatide plus insulin glargine (2016); semaglutide (2017); and tirzepatide (2022) (FDA, 2026b). The drug class has evolved from early agents (e.g., exenatide) to long-acting formulations (e.g., semaglutide) to newer dual GLP-1s and GIPs (e.g., tirzepatide) (Darwish et al., 2025; FDA, 2026b). Drug side effects include nausea, vomiting, diarrhea, constipation, hair loss, muscle loss, injection site reactions, pancreatitis, and allergic reactions (Jalleh et al., 2026; Zheng et al., 2024). Additional GLP-1s are currently under investigation as single-, dual-, and triple-agent therapies for type 2 diabetes and obesity (FDA, 2026b; Zheng et al., 2024), and there are promising clinical trial data for GLP-1s in various substance use disorders (Patil et al., 2026).

GLP-1s have rapidly expanded in use because of their broad metabolic, cardiovascular, and anti-inflammatory benefits (Darwish et al., 2025; Zheng et al., 2024). Independently, a 2025 RAND report by Bozick et al. and a 2025 Kaiser Family Foundation survey found that about 12% of Americans are currently taking a GLP-1, with nearly 20% of women reporting such use. Li et al. (2025) found a marked increase in prescribing trends across GLP-1 indications and subpopulations from 2010 to 2025, particularly after the introduction of semaglutide and tirzepatide. This may be a result of widespread media attention, direct-to-consumer messaging, or increasing GLP-1 compounding. Subsequently, the FDA (2026a) has expressed safety, effectiveness, and quality concerns for consumers. As prescribing expands in the general population—and as patients with cancer, type 2 diabetes, or obesity become eligible for GLP-1s, or inquire about them because of weight gain during cancer care—oncology nurses are increasingly likely to encounter patients who are receiving these medications. As such, oncology nurses can bolster their knowledge of GLP-1s to advance Quintuple Aim cancer care.

Because of GLP-1s’ mechanisms of action and anticipated long-term outcomes, clinicians have raised questions about their relationship to cancer. Evidence is evolving and often conflicting. Data indicate an overall lower risk of hepatocellular carcinoma and colorectal, pancreatic, endometrial, esophageal, gallbladder, and ovarian cancers, as well as multiple myeloma (Ateiwi et al., 2026; Dai et al., 2025). A few studies suggest increased lifetime risks of pancreatic and thyroid cancer, but most evidence indicates no differences in risk for these two cancers (Ateiwi et al., 2026; Dai et al., 2025; Jalleh et al., 2026; Ko et al., 2026; Silverii et al., 2025). In contrast, large meta-analyses of randomized controlled trials have found little to no effect on most cancers, including pancreatic, thyroid, breast, and kidney (Ko et al., 2026; Silverii et al., 2025).

Emerging data in cancer survivors add further complexity. Retrospective cohort studies have demonstrated improved overall survival among patients receiving GLP-1s, particularly in breast cancer populations, but have not consistently shown improvements in disease-free survival (Nelson et al., 2026; Sukumar et al., 2026). These findings are promising but require cautious interpretation and further investigation while numerous GLP-1 studies are in progress across numerous specialties (Zheng et al., 2024). A conflicting 2026 preprint of Gruber et al.’s National Institutes of Health–funded multisite work, now undergoing peer review, has indicated that GLP-1 use in patients with triple-negative breast cancer shows significantly reduced pathologic complete response rates (30.8%) compared to the control cohort (65%) (p < 0.001), as well as GLP-1 medications inducing paclitaxel resistance in the triple-negative breast cancer population. Although preliminary and not yet practice-changing, such findings underscore the need for vigilance.

Despite conflicting evidence on the relationship between GLP-1s and long-term cancer care outcomes, there are immediate implications for oncology nursing practice. First, symptom assessment may become more complex in those with cancer. GLP-1s commonly cause gastrointestinal adverse effects, like nausea, vomiting, and diarrhea, with reported rates as high as 20%–40% (Jalleh et al., 2026; Zheng et al., 2024). These symptoms overlap with those associated with cancer treatments, complicating attribution and management. Nurses must increasingly differentiate between treatment- and medication-related toxicities in real time.

Second, GLP-1–induced appetite suppression introduces tension within oncology nutrition management. Although weight loss may be beneficial for some patients, others may experience unintended harm. Oncology nurses can help counsel patients, monitor nutritional status, and coordinate care with dietitians.

Third, safety considerations extend beyond symptom management. GLP-1s delay gastric emptying, increasing the risk of retained gastric contents and aspiration during procedures requiring sedation or anesthesia (Jalleh et al., 2026). This has direct implications for preprocedural assessment and interdisciplinary communication.

Lastly, there is a paucity of oncology nursing literature addressing GLP-1s. Although multidisciplinary studies are rapidly emerging, oncology nursing has yet to meaningfully contribute to the related evidence base. This gap is consequential, as oncology nurses are already managing the clinical implications of these therapies. Doctorally prepared oncology nurses can begin closing this evidence gap.

GLP-1s represent another variable in an already complex field. But they also represent an opportunity. Oncology nurses have the ability and ongoing responsibility to safeguard patients in this space, including integrating GLP-1 considerations into routine assessment, educating patients about realistic expectations and potential risks, coordinating with interprofessional colleagues, and contributing to the evidence through practice-based and novel research and publication.