Can Mebendazole (MBZ) be taken with Lenvatinib (Lenvima) and Pembrolizumab (Pembro, Keytruda)?

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Last updated: May 15, 2025View editorial policy

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From the Guidelines

I strongly advise against taking Mebendazolum with lenvatinib and pembro without consulting your healthcare provider first, as the potential for drug interactions and complications in cancer treatment is high. The provided evidence does not directly address the interaction between Mebendazolum and lenvatinib plus pembrolizumab, but it highlights the complex side effect profiles of lenvatinib and pembrolizumab in cancer treatment, as seen in the CLEAR trial 1 and the LEAP-002 study 1. Mebendazole is an antiparasitic medication, while lenvatinib is a kinase inhibitor and pembrolizumab is an immunotherapy drug, and their combination could potentially alter the effectiveness of cancer treatment or increase side effects.

The CLEAR trial 1 demonstrated the efficacy of lenvatinib plus pembrolizumab in treating metastatic clear cell renal cell carcinoma, with improved progression-free survival (PFS) and overall survival (OS) compared to sunitinib. However, the trial also reported significant grade 3 or higher adverse events (AEs) in 82.4% of patients receiving lenvatinib plus pembrolizumab. Similarly, the LEAP-002 study 1 found that grade 3-5 treatment-related AEs were 62.5% in the lenvatinib plus pembrolizumab group.

Given the potential risks and the lack of direct evidence on the interaction between Mebendazolum and lenvatinib plus pembrolizumab, it is crucial to consult with a healthcare provider before taking Mebendazolum with these medications. The healthcare provider can evaluate the risks and benefits in the specific situation and suggest alternative treatments or appropriate timing for Mebendazolum if necessary. Key considerations include:

  • The potential for drug interactions and complications in cancer treatment
  • The complex side effect profiles of lenvatinib and pembrolizumab
  • The importance of consulting with a healthcare provider before taking Mebendazolum with these medications
  • The need for careful calibration of cancer treatment regimens to avoid interference with the balance of medications.

From the Research

Interaction between Mebendazolum and Lenvatinib with Pembrolizumab

  • There is no direct evidence in the provided studies regarding the interaction between Mebendazolum and Lenvatinib with Pembrolizumab 2, 3, 4, 5, 6.
  • Mebendazolum is an anti-parasitic drug, and its use in cancer treatment is being explored, particularly in its ability to inhibit microtubule systems of parasites and mammalian cells, leading to cell death 2.
  • Lenvatinib and Pembrolizumab are used in combination for the treatment of various cancers, including renal cell carcinoma and endometrial cancer, with studies showing promising antitumor activity and manageable toxicities 3, 4, 5, 6.
  • However, the safety and efficacy of combining Mebendazolum with Lenvatinib and Pembrolizumab are unknown due to the lack of direct evidence in the provided studies.

Potential Considerations

  • When considering the use of Mebendazolum with Lenvatinib and Pembrolizumab, potential interactions and toxicities should be taken into account, although there is no direct evidence to support or refute this combination 2, 3, 4, 5, 6.
  • The decision to use Mebendazolum with Lenvatinib and Pembrolizumab should be made on a case-by-case basis, considering the individual patient's condition, medical history, and potential risks and benefits.
  • Further research is needed to determine the safety and efficacy of this combination.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Combined use of pembrolizumab and lenvatinib: A review.

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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