Ivermectin is NOT a Recommended Treatment for Prostate Cancer
Ivermectin should not be used for prostate cancer treatment—no clinical guidelines from major oncology societies recommend it, and there is no high-quality clinical evidence demonstrating efficacy or safety in humans with prostate cancer. 1
Why Ivermectin is Not Recommended
Absence from Evidence-Based Guidelines
The most recent and authoritative prostate cancer treatment guidelines make no mention of ivermectin as a therapeutic option:
ESMO 2023 guidelines provide comprehensive treatment algorithms for all stages of prostate cancer (localized, metastatic hormone-sensitive, and castration-resistant disease) without any reference to ivermectin 1
Established treatments for metastatic castration-resistant prostate cancer include androgen deprivation therapy (ADT) combined with novel hormone agents (abiraterone, enzalutamide, apalutamide, darolutamide), chemotherapy (docetaxel, cabazitaxel), PARP inhibitors (olaparib for BRCA mutations), and radionuclide therapy (177Lu-PSMA-617) 1
For localized high-risk disease, external beam radiotherapy plus ADT with abiraterone/prednisone, or radical prostatectomy with pelvic lymphadenectomy are recommended 1
Preclinical Data Does Not Equal Clinical Efficacy
While laboratory studies show ivermectin has effects on prostate cancer cells in petri dishes, this does not translate to clinical recommendations:
In vitro studies demonstrate ivermectin can arrest cell cycle, induce apoptosis, and target proteins like FOXA1 and Ku70/Ku80 in prostate cancer cell lines 2
Animal studies show tumor reduction in mice 3
Critical gap: The prostate cancer cell line DU145 was actually the most resistant to ivermectin among 28 cancer cell lines tested, suggesting limited efficacy specifically in prostate cancer 3
No human clinical trials have evaluated ivermectin for prostate cancer treatment with proper endpoints (overall survival, progression-free survival, quality of life) 2, 3, 4, 5, 6
Concentration and Safety Concerns
Pharmacokinetic mismatch: In vitro anti-SARS-CoV-2 activity required concentrations "considerably higher than those achieved in human plasma and lung tissue" 1—similar concerns exist for anticancer effects
Uncontrolled observational data: A 2023 study from Ecuador reported cancer patients using ivermectin as alternative therapy, but this was uncontrolled observation without scientific validation of outcomes 4
No authorization: Medical specialists interviewed confirmed "there is no authorization to prescribe these alternative treatments" and "no scientific knowledge about the application of these treatments in humans" for cancer 4
What Should Be Used Instead
For Metastatic Hormone-Sensitive Prostate Cancer (mHSPC)
First-line triplet therapy: ADT + docetaxel + abiraterone/prednisone for fit patients with high-volume disease (multiple bone metastases >3 or visceral metastases) [ESMO-MCBS score: 4] 1
Alternative first-line: ADT + docetaxel + darolutamide [ESMO-MCBS score: 4] 1
Novel hormone agent doublet: ADT + abiraterone/prednisone, apalutamide, or enzalutamide [ESMO-MCBS score: 4] 1
For Metastatic Castration-Resistant Prostate Cancer (mCRPC)
After progression on androgen receptor axis inhibitors and docetaxel:
177Lu-PSMA-617 for PSMA-expressing tumors without non-expressing lesions (median OS: 15.3 vs 11.3 months; HR 0.62) [ESMO-MCBS score: 4] 1, 7
Cabazitaxel [ESMO-MCBS score: 3] 1
Olaparib for BRCA1/2 alterations [ESMO-MCBS score: 3] 1
Critical Pitfall to Avoid
Do not delay evidence-based treatment by pursuing unproven therapies like ivermectin. Prostate cancer treatment has dramatically improved with novel agents showing substantial survival benefits (e.g., 33-month OS gain with abiraterone in STAMPEDE trial) 1. Delaying these proven therapies while pursuing experimental approaches without clinical validation risks disease progression and loss of treatment opportunities, particularly for aggressive disease 1.
The burden of proof for any cancer treatment requires randomized controlled trials demonstrating improved mortality, morbidity, or quality of life—ivermectin has none of this evidence for prostate cancer 1.