Antioxidants in Januvia May Promote Cancer Metastasis

April 28, 2016 — A new study in mice has found that antioxidants in diabetes drugs like Januvia may protect cancer cells and promote the spread of pre-existing tumors.

Antioxidants protect cells against oxidative stress, which normally reduces the risk of cancer. In this case, they appear to protect cancer cells and accelerate tumor growth, making it easier for cancer to spread to other parts of the body (metastasize).

The study was published in Science Translational Medicine by Hui Wang and colleagues, who warned that the drugs “may need to be administered with caution in diabetic patients with existing cancer.”

DPP-4 inhibitors did not appear to increase the formation of new cancers, but they did promote the spread of pre-existing colon and liver tumors in mice. It is still unknown whether this risk applies to people, but researchers told TIME that the effect may be more pronounced in people with genetic risk-factors.

Last year, a provocative study published in Nature found that antioxidants can “turbo-charge” cancer growth and metastasis.

The metastasis of cancer to other parts of the body is an inefficient process, with many cells dying along the way due to oxidative stress from “free radicals” in the body. When antioxidants are given, they may protect dying cancer cells and increase proliferation.

In 2014, another study published in Science Translational Medicine found that antioxidants tripled the number of aggressive tumors in rodents with lung cancer and doubled the risk of death. The mice were given normal doses of antioxidants like Vitamin E and N-acetylcysteine (NAC).

This is not the first time DPP-4 inhibitors have been linked to cancer. In March 2013, the FDA investigated reports linking Januvia with pancreatitis (pancreas inflammation) and pre-cancerous growths. In 2009, the FDA asked the makers of Byetta to “explore a potential signal of a serious risk of thyroid cancer and pancreatic cancer.”

List of FDA approved DPP-4 inhibitors:

• Glyxambi (empagliflozin/linagliptin)
• Janumet XR (sitagliptin/metformin HCl)
• Janumet (sitagliptin/metformin HCl)
• Januvia (sitagliptin)
• Jentadueto (linagliptin/metformin HCl)
• Kazano (alogliptin/metformin HCl)
• Kombiglyze XR (saxagliptin/metformin HCl)
• Nesina (alogliptin)
• Onglyza (saxagliptin)
• Oseni (alogliptin/pioglitazone)
• Tradjenta (linagliptin)

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