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Ivermectin and Mebendazole in Cancer Patients https://zenodo.org/records/19455636 The Clinical Benefit Ratio Complete Response + Partial Response + Stable Disease / Total Patients (CBR) was 84.4% Overall, it is estimated that annual costs of standard chemotherapies average $111,000 per year. Background: Drug repurposing offers a pathway to identify accessible, low-toxicity cancer therapies. Ivermectin and mebendazole have demonstrated multi-target anti-cancer activity. This paper evaluates real-world patient-reported outcomes, safety, and adherence in a cohort of cancer patients utilizing this combination protocol. Methods: Prospective observational cohort of 197 cancer patients, who were prescribed ivermectin and mebendazole off-label through telemedicine (platform by licensed U.S. healthcare providers) Participants received compounded oral capsules containing 25 mg ivermectin and 250 mg mebendazole. 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) Results: Mean age of 67 years, (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% Gynaecologic 2.5% Hematologic 2.5% Median duration since initial diagnosis, 1.2 years 37.1% experiencing active disease progression. 6-month follow-up Medication adherence, 86.9% Full initial 90-capsule ivermectin-mebendazole prescription. The Clinical Benefit Ratio Complete Response + Partial Response + Stable Disease / Total Patients (CBR) was 84.4% Notably, 48.4% of cohort, strongest positive outcomes: Regression, 15.6% No current evidence of disease (NED), 32.8% Disease stability, 36.1% Disease progression, 15.6% No significant dose-response association was observed for cancer outcomes (p = 0.91), without a clear dose-response gradient for efficacy. Side effects Mild side effects (primarily gastrointestinal), 25.4% (93.6% of those affected continued treatment through minor dose adjustments) Concurrent conventional therapies Chemotherapy, 27.9% Radiation therapy, 21.3% Surgery, 19.7% Adjunctive interventions such as supplement use, 49.2% Dietary modification, 37.7% Conclusions: 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 tumours 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, 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 Validate these observations and further define optimal dosing strategies. Mechanism (pharmacodynamics) Ivermectin and mebendazole are antiparasitic agents, demonstrated highly promising anti-cancer activity. Ivermectin Shown to exert over 14 distinct anti-cancer mechanisms across more than 12 cancer types, inhibiting cancer cell proliferation, metastasis, angiogenesis, mitochondrial function. Has demonstrated excellent safety in cancer patients (including those actively undergoing chemotherapy) Ivermectin and mebendazole selectively target cancer stem cells Mebendazole Microtubule disruption, leading to effective cell cycle arrest Potent induction of apoptosis Significant inhibition of tumour growth Inhibition of angiogenesis Disruption of glucose uptake When used together Target non-overlapping pathways, resulting in synergistic tumour regression, cancer stem cell depletion, and reversal of multidrug resistance in multiple in vitro and in vivo models Biodistribution, ivermectin and mebendazole document excellent tissue penetration

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