GLP-1 Receptor Agonists in Breast Cancer Survivorship: Current Evidence, Biological Rationale, and Clinical Implications

Kathy M. Mahalati, MD, PhD, Douglas L. Forman, MD, FACS and John O. Collins, MD

Department of Obstetrics and Gynecology, University of Maryland Medical Systems, USA Department of Plastic Surgery, Georgetown University School of Medicine and Department of Plastic and Reconstructive Surgery, Johns Hopkins University, USA Dupont Integrative Neurological Center/ Fort Wayne Neuro Center Associates, USA

^*Correspondance to: Kathy M. Mahalati 

 PDF  Full Text Review Article | Open Access

Abstract:

Breast cancer survivorship has evolved into a multidimensional phase of care that extends well beyond completion of cancer treatment. Obesity, treatment-associated weight gain, metabolic dysfunction, chronic inflammation, fatigue, sleep disturbance, cardiovascular disease, chronic pain, and impaired quality of life contribute substantially to long-term morbidity. As the population of breast cancer survivors continues to grow, optimizing recovery increasingly requires therapeutic strategies that address not only metabolic disease but also the biological, functional, and patientcentered determinants of long-term health. Glucagon-Like Peptide-1 (GLP-1) receptor agonists are established therapies for obesity, type 2 diabetes, and cardiometabolic disease. Beyond these proven metabolic benefits, accumulating evidence suggests that GLP-1 signaling influences multiple biological processes relevant to survivorship, including inflammatory regulation, immune function, neuroimmune communication, autonomic balance, mitochondrial bioenergetics, and stress physiology. These pleiotropic effects have generated growing interest in the potential role of GLP-1 receptor agonists within comprehensive survivorship care aimed at improving metabolic health, physical function, and physiological resilience. This narrative review examines the current evidence supporting GLP-1 receptor agonists in breast cancer survivorship. We review major survivorship challenges that intersect with GLP-1 biology including obesity, metabolic dysfunction, chronic inflammation, fatigue, sleep disturbance, and persistent pain while summarizing emerging evidence on the metabolic, neuroimmune, and systemic effects of GLP-1 signaling. Particular emphasis is placed on distinguishing established clinical evidence from evolving mechanistic hypotheses and considering the potential implications of these therapies for long-term health, functional recovery, and quality of life. Current evidence is strongest for weight management, glycemic control, metabolic health, and cardiovascular risk reduction, whereas survivorship-specific clinical data remain limited. Future research should extend beyond traditional metabolic endpoints to include body composition, preservation of skeletal muscle, physical function, symptom burden, patient-reported outcomes, quality of life, and healthy aging. Such multidimensional investigations will be essential for defining the evidence-based role of GLP-1 receptor agonists within comprehensive, multidisciplinary survivorship care.

Keywords:

Breast cancer survivorship; GLP-1 receptor agonists; Cancer survivorship; Obesity; Metabolic health; Quality of life; Weight management; Cardiovascular health

Cite the Article:

Mahalati KM, Forman DL, Collins JO. GLP-1 Receptor Agonists in Breast Cancer Survivorship: Current Evidence, Biological Rationale, and Clinical Implications. Ann Clin Case Rep. 2026; 11: 2847..