{"id":10950,"date":"2025-12-18T06:30:00","date_gmt":"2025-12-18T09:30:00","guid":{"rendered":"https:\/\/gastropedia.pub\/pt\/?p=10950"},"modified":"2025-12-12T12:22:23","modified_gmt":"2025-12-12T15:22:23","slug":"agonistas-de-receptores-de-glp-1glp-1-ra-e-neoplasia-pancreatica-existe-associacao","status":"publish","type":"post","link":"https:\/\/gastropedia.pub\/pt\/gastroenterologia\/agonistas-de-receptores-de-glp-1glp-1-ra-e-neoplasia-pancreatica-existe-associacao\/","title":{"rendered":"Agonistas de Receptores de GLP-1(GLP-1-RA) e neoplasia pancre\u00e1tica: existe associa\u00e7\u00e3o?"},"content":{"rendered":"
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Em rela\u00e7\u00e3o aos novos tratamentos propostos para diabetes mellitus e obesidade (os agonistas de receptores de GLP-1 e os agonistas duplos de GLP-1 + GIP), j\u00e1 discutimos em outra publica\u00e7\u00e3o que o risco de pancreatite aguda parece ser aumentado em algumas popula\u00e7\u00f5es, enquanto na maior parte dos pacientes o risco n\u00e3o \u00e9 aumentado (Clique aqui para conferir o artigo: Pancreatite induzida por an\u00e1logos de GLP-1: mito ou preocupa\u00e7\u00e3o?<\/a>).<\/p>\n\n\n\n

Por\u00e9m, outra d\u00favida que surge \u00e9: o uso dessas medica\u00e7\u00f5es poderia aumentar o o risco de neoplasia pancre\u00e1tica?<\/strong><\/p>\n\n\n\n

Um dado importante a se ressaltar \u00e9 que o <\/em>Diabetes mellitus<\/em> e a obesidade<\/strong> (ambas doen\u00e7as tratadas pelos agonistas de receptores de GLP-1\/GIP) s\u00e3o fatores de risco para c\u00e2ncer de p\u00e2ncreas<\/strong>. Pacientes com DM t\u00eam risco aumentado de neoplasia pancre\u00e1tica em 1,5-2,4 vezes. J\u00e1 os pacientes com sobrepeso e obesidade t\u00eam risco relativo (RR) de 1,19 a 1,62 de desenvolver essa patologia. Portanto, ambas as doen\u00e7as s\u00e3o consideradas fatores de risco para neoplasia pancre\u00e1tica, mais especificamente adenocarcinoma ductal de p\u00e2ncreas.<\/p>\n\n\n\n


O que dizem os estudos<\/strong>?<\/h2>\n\n\n\n

Em modelos animais<\/strong>, especulou-se<\/strong> que a estimula\u00e7\u00e3o cr\u00f4nica do receptor do GLP-1 pudesse aumentar o risco de pancreatite, e como consequ\u00eancia, de c\u00e2ncer de p\u00e2ncreas<\/strong>. Baseado nisso, e em relatos de eventos adversos, algumas ag\u00eancias regulat\u00f3rias (como o FDA, por exemplo) contra-indicaram o uso dessas medica\u00e7\u00f5es em pessoas que tivessem hist\u00f3ria familiar de c\u00e2ncer de p\u00e2ncreas e neoplasia end\u00f3crina m\u00faltipla. Esses “avisos” permanecem at\u00e9 hoje, mesmo com surgimento de novas evid\u00eancias.<\/p>\n\n\n\n

Esses resultados n\u00e3o se confirmaram em ensaios cl\u00ednicos randomizados e nem em coortes retrospectivas<\/strong>. Nesses trabalhos a incid\u00eancia de neoplasia pancre\u00e1tica foi igual nos grupos que usavam os GLP-1-RA ou outros tratamentos para diabetes, como metformina, sulfonilureias e insulina. Da mesma forma, outra coorte retrospectiva demonstrou que o uso de GLP-1-RA em pacientes diab\u00e9ticos demonstrou redu\u00e7\u00e3o em 10 de 13 neoplasias associadas a obesidade (colorretal, p\u00e2ncreas, ves\u00edcula biliar, ov\u00e1rio, meningioma, hepatocelular, mieloma m\u00faltiplo, esof\u00e1gico, endom\u00e9trio e rim)<\/strong>. Houve redu\u00e7\u00e3o tamb\u00e9m em neoplasia g\u00e1strica, por\u00e9m n\u00e3o estatisticamente significante.<\/p>\n\n\n\n

Poucos estudos analisaram o risco de neoplasia com tirzepatida (duplo agonista GLP-1 e GIP). Por ser uma medica\u00e7\u00e3o de uso mais recente, os trabalhos analisaram um per\u00edodo curto (no m\u00e1ximo 18 meses) – e neste per\u00edodo n\u00e3o houve incremento da incid\u00eancia de neoplasias no grupo que fez uso da droga, comparativamente com placebo.<\/p>\n\n\n\n


Mas e quanto aos tumores neuro-end\u00f3crinos?<\/strong><\/h2>\n\n\n\n

A maior d\u00favida reside quanto \u00e0 neoplasia neuroend\u00f3crina pancre\u00e1tica, que esteja em seguimento cl\u00ednico (n\u00e3o cir\u00fargico). Os impactos dos GLP-1-RA nos tumores neuroend\u00f3crinos ainda \u00e9 pouco estudado<\/strong>. Em um estudo experimental, os tumores que expressam receptor de GLP-1 (no trabalho, 50% deles expressavam), tiveram crescimento com o uso da semaglutida (agonista de receptor de GLP-1). Entretanto n\u00e3o h\u00e1 conclus\u00e3o sobre desfechos cl\u00ednico-cir\u00fargicos<\/strong>.<\/p>\n\n\n\n


Conclus\u00f5es<\/strong><\/h2>\n\n\n\n

As medica\u00e7\u00f5es agonistas de receptores GLP-1 \/ GIP parecem n\u00e3o elevar o risco de neoplasia pancre\u00e1tica<\/strong>, podendo ser prescritas com seguran\u00e7a. Ressalva feita no caso de tumores neuro-end\u00f3crinos em seguimento<\/strong> devido a poucos estudos endere\u00e7ando este tema.<\/p>\n\n\n\n

Refer\u00eancias<\/strong><\/h2>\n\n\n\n
    \n
  1. Klein, A.P. Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors. Nat Rev Gastroenterol Hepatol<\/em> 18, 493\u2013502 (2021). https:\/\/doi.org\/10.1038\/s41575-021-00457-x<\/u><\/a><\/li>\n\n\n\n
  2. Kim M, Kim SC, Kim J, Kim BH. Use of Glucagon-Like Peptide-1 Receptor Agonists Does Not Increase the Risk of Cancer in Patients with Type 2 Diabetes Mellitus. Diabetes Metab J 2025;49:49-59.
    https:\/\/doi.org\/10.4093\/dmj.2024.0105<\/u><\/a><\/li>\n\n\n\n
  3. Dankner R, Murad H, Agay N, Olmer L, Freedman LS. Glucagon-Like Peptide-1 Receptor Agonists and Pancreatic Cancer Risk in Patients With Type 2 Diabetes. JAMA Netw Open. 2024 Jan 2;7(1):e2350408. doi: 10.1001\/jamanetworkopen.2023.50408.<\/li>\n\n\n\n
  4. Kamrul-Hasan ABM, Alam MS, Dutta D, Sasikanth T, Aalpona FTZ, Nagendra L. Tirzepatide and Cancer Risk in Individuals with and without Diabetes: A Systematic Review and Meta-Analysis. Endocrinol Metab (Seoul). 2025 Feb;40(1):112-124. doi: 10.3803\/EnM.2024.2164.<\/li>\n\n\n\n
  5. Shilyansky JS, Chan CJ, Xiao S, Gribovskaja-Rupp I, Quelle DE, Howe JR, Dillon JS, Ear PH. GLP-1R agonist promotes proliferation of neuroendocrine neoplasm cells expressing GLP-1 receptors. Surgery. 2025 Mar;179:108943. doi: 10.1016\/j.surg.2024.09.052.<\/li>\n<\/ol>\n\n\n\n

    Como citar este artigo<\/strong><\/h2>\n\n\n\n

    Marzinotto M. Agonistas de Receptores de GLP-1(GLP-1-RA) e sua associa\u00e7\u00e3o com neoplasia pancre\u00e1tica. Gastropedia 2025, Vol II. Dispon\u00edvel em: https:\/\/gastropedia.pub\/pt\/gastroenterologia\/agonistas-de-receptores-de-glp-1glp-1-ra-e-sua-associacao-com-neoplasia-pancreatica\/<\/a><\/p>\n\n\n\n

    <\/p>\n","protected":false},"excerpt":{"rendered":"

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