Abstract
\nBackground: Drug repurposing offers a pathway to identify accessible, low-toxicity cancer therapies. Ivermectin and mebendazole have demonstrated multi-target anti-cancer activity in preclinical models, including the inhibition of cancer cell proliferation and the targeting of cancer stem cells. This paper evaluates real-world patient-reported outcomes, safety, and adherence in a cohort of cancer patients utilizing this combination protocol.
\nMethods: We analyzed a prospective observational cohort of 197 cancer patients who were prescribed ivermectin and mebendazole off-label through a telemedicine platform by licensed U.S. healthcare providers. Participants received compounded oral capsules containing 25 mg ivermectin and 250 mg mebendazole. As part of a clinical program evaluation, data were collected via voluntary, standardized digital surveys at baseline and at approximately 6-month follow-up. Of the initial cohort (N = 197), baseline characteristics, including cancer type and disease status, were assessed. A total of 122 participants completed the follow-up survey (61.9% response rate) to evaluate self-reported cancer outcomes, medication adherence, and adverse events. 95% confidence intervals (CI) were calculated for primary outcome measures using the Wilson score method. Dose-stratified analyses for outcomes and safety were conducted using Chi-square statistics.
\nResults: The cohort represented a diverse clinical profile of cancer patients, with mean age of 67 years and nearly balanced sex distribution (52.3% male, 47.7% female). Cancer types included prostate (27.9%), breast (18.3%), lung (8.6%), colon (5.1%), urologic (4.6%), pancreatic (3.0%), liver (2.5%), gynecologic (2.5%), and hematologic (2.5%) malignancies. At enrollment, participants had a median duration since initial diagnosis of 1.2 years, with 37.1% experiencing active disease progression. At 6-month follow-up, medication adherence was high with 86.9% of participants completing the full initial 90-capsule ivermectin-mebendazole prescription and 66.4% remaining on the protocol at 6 months. The Clinical Benefit Ratio (CBR) was 84.4% (95% CI: 77.0–89.8%). Notably, 48.4% (95% CI: 39.7–57.1%) of the cohort reported the strongest positive outcomes, consisting of regression (15.6%; 95% CI: 10.2–23.0%) or no current evidence of disease (NED, 32.8%; 95% CI: 25.1–41.5%). Disease stability was reported to be maintained in 36.1% (95% CI: 28.1–44.9%) of participants, while 15.6% (95% CI: 10.2–23.0%) reported disease progression. While 25.4% reported mild side effects (primarily gastrointestinal), 93.6% of those affected continued treatment through minor dose adjustments. Some participants reported concurrent conventional therapies, including chemotherapy (27.9%), radiation therapy (21.3%), and surgery (19.7%), as well as adjunctive interventions such as supplement use (49.2%), dietary modification (37.7%), and other integrative approaches.
\nConclusions: In this prospective real-world cohort, the combination of ivermectin and mebendazole was associated with high rates of self-reported clinical benefit, with nearly half of participants reporting tumor regression or no current evidence of disease across a heterogeneous population of cancer patients. These findings provide a compelling clinical signal that these well-tolerated, repurposed agents may offer therapeutic benefit. However, given the observational design, reliance on self-reported outcomes, and potential for selection bias and uncontrolled confounding, these findings should be interpreted as hypothesis-generating. Urgent prospective, randomized, placebo-controlled clinical trials are warranted to validate these observations and further define optimal dosing strategies.
", "publication_date": "2026-04-07", "publisher": "Zenodo", "resource_type": { "id": "publication-preprint", "title": { "de": "Preprint", "en": "Preprint" } }, "rights": [ { "description": { "en": "The Creative Commons Attribution license allows re-distribution and re-use of a licensed work on the condition that the creator is appropriately credited." }, "icon": "cc-by-icon", "id": "cc-by-4.0", "props": { "scheme": "spdx", "url": "https://creativecommons.org/licenses/by/4.0/legalcode" }, "title": { "en": "Creative Commons Attribution 4.0 International" } } ], "title": "Real-World Clinical Outcomes of Ivermectin and Mebendazole in Cancer Patients: Results from a Prospective Observational Cohort" }, "parent": { "access": { "owned_by": { "user": "579652" }, "settings": { "accept_conditions_text": null, "allow_guest_requests": false, "allow_user_requests": false, "secret_link_expiration": 0 } }, "communities": {}, "id": "19455635", "pids": { "doi": { "client": "datacite", "identifier": "10.5281/zenodo.19455635", "provider": "datacite" } } }, "pids": { "doi": { "client": "datacite", "identifier": "10.5281/zenodo.19455636", "provider": "datacite" }, "oai": { "identifier": "oai:zenodo.org:19455636", "provider": "oai" } }, "revision_id": 4, "stats": { "all_versions": { "data_volume": 1118572005460.0, "downloads": 103287, "unique_downloads": 86559, "unique_views": 89123, "views": 97443 }, "this_version": { "data_volume": 1118572005460.0, "downloads": 103287, "unique_downloads": 86559, "unique_views": 89123, "views": 97443 } }, "status": "published", "swh": {}, "updated": "2026-04-07T15:24:41.900537+00:00", "versions": { "index": 1, "is_latest": true } }