Ivermectin and Fenbendazole Are Not Recommended for Prostate Cancer Treatment
Neither ivermectin nor fenbendazole are recommended for the treatment of prostate cancer as they are not included in any established clinical guidelines and lack sufficient clinical evidence supporting their efficacy or safety for this indication. 1
Current Standard of Care for Prostate Cancer
The 2023 European Society for Medical Oncology (ESMO) guidelines provide clear, evidence-based recommendations for prostate cancer treatment based on disease stage:
For Non-Metastatic Disease:
- External beam radiotherapy plus ADT with abiraterone/prednisone for high-risk localized disease 1
- Long-course ADT (24-36 months) plus abiraterone/prednisone (24 months) for very high-risk disease 1
For Metastatic Hormone-Sensitive Prostate Cancer (mHSPC):
- ADT plus docetaxel plus abiraterone/prednisone for fit patients with de novo mHSPC 1
- ADT plus docetaxel plus darolutamide as an alternative first-line option 1
- ADT plus novel hormone agents (abiraterone/prednisone, apalutamide, or enzalutamide) 1
For Metastatic Castration-Resistant Prostate Cancer (mCRPC):
- 177Lu-PSMA-617 for PSMA-expressing cancers after prior novel androgen receptor inhibitor and taxane therapy 1
- Cabazitaxel after progression on prior therapies 1
- Olaparib for patients with BRCA1/2 alterations 1
Ivermectin in Prostate Cancer Research
While there is some preclinical research on ivermectin in cancer:
- A 2022 study identified potential anticancer mechanisms of ivermectin in prostate cancer cell lines, suggesting it may affect FOXA1 and Ku70/Ku80 proteins 2
- Laboratory studies have shown ivermectin may cause G0/G1 cell cycle arrest and induce apoptosis in prostate cancer cells 2
- Some in vivo studies demonstrated suppression of prostate cancer xenograft progression 2
However, these findings are limited to preclinical models and have not translated to clinical trials or guideline recommendations. The concentrations required for anticancer effects may not be safely achievable in humans.
Fenbendazole and Prostate Cancer
There is a notable absence of published research specifically on fenbendazole for prostate cancer treatment in the provided evidence. No clinical trials, case reports, or even preclinical studies were presented that evaluate fenbendazole's efficacy or safety in prostate cancer.
Important Considerations and Risks
Lack of Clinical Evidence: Neither drug has completed the rigorous clinical trials necessary to establish efficacy and safety for cancer treatment 1
Potential Toxicity: The doses required for potential anticancer effects may exceed safe human dosing levels
Delay in Effective Treatment: Pursuing unproven therapies may delay patients from receiving evidence-based treatments that have demonstrated survival benefits
Regulatory Status: These medications are not FDA or EMA approved for cancer treatment
Clinical Decision Algorithm
For patients inquiring about ivermectin or fenbendazole for prostate cancer:
Assess disease stage and determine appropriate evidence-based treatment according to current guidelines 1
Discuss established treatment options with proven survival benefits:
- For localized disease: surgery, radiation, or active surveillance
- For metastatic disease: ADT plus appropriate additional agents as recommended by ESMO 1
Address patient concerns about conventional treatments and explain the robust evidence supporting their use
Explain the lack of clinical evidence for ivermectin and fenbendazole in prostate cancer treatment
Consider clinical trial participation if appropriate for the patient's disease stage
Conclusion
While some preclinical research suggests potential anticancer mechanisms for ivermectin, there is insufficient clinical evidence to support its use in prostate cancer treatment. For fenbendazole, there is even less evidence available. Patients should be strongly encouraged to pursue established, evidence-based treatments that have demonstrated improvements in survival and quality of life.