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Cancer 128 , 958966 (2023)

During the shortage, clinicians are also required to: Only prescribe GLP-1 RAs for their licensed indication Review the need for prescribing a GLP-1 RA agent and stop treatment if no longer required due to not achieving desired clinical effect as per NICE CG28 Avoid switching between brands of GLP-1 RAs, including between injectable and oral forms Where a higher dose preparation of GLP-1 RA is not available, do not substitute by doubling up a lower dose preparation Where GLP-1 RA therapy is not available, proactively identify patients established on the affected preparation and consider prioritising for review based on the criteria below

however, the progression from low-grade PanINs to PDAC involves sustained proliferation leading to the accumulation of somatic mutations and typically spans for longer than a decade 20,31