From the Research
Zepbound (tirzepatide) should be used with caution in patients with neuroendocrine tumors, as the current evidence does not provide a clear recommendation for or against its use in this population. The most recent and highest quality study on this topic is not available, but studies on metformin and its effects on neuroendocrine tumors suggest that it may have anticancer properties 1, 2, 3, 4. However, tirzepatide is a GIP and GLP-1 receptor agonist, and its effects on neuroendocrine tumors are not well understood.
Key Considerations
- The FDA has placed a boxed warning on tirzepatide and similar medications due to their potential association with thyroid C-cell tumors in rodent studies 5.
- GLP-1 receptors are expressed on thyroid C-cells and other neuroendocrine tissues, and prolonged stimulation could potentially promote tumor growth.
- Metformin, a biguanide, has been shown to have antitumor effects in neuroendocrine tumor cells in vitro and may be a potential therapeutic option for patients with neuroendocrine tumors 3, 4.
Recommendations
- Healthcare providers should perform a careful risk assessment before prescribing Zepbound to patients with any history of neuroendocrine tumors.
- Patients taking Zepbound should be counseled to report symptoms such as a mass in the neck, difficulty swallowing, persistent hoarseness, or shortness of breath, which could indicate thyroid tumors.
- Further research is needed to fully understand the effects of tirzepatide on neuroendocrine tumors and to determine its safety and efficacy in this population.