In Silico Evaluation of Ivermectin, Mebendazole, Metformin, High-Dose Vitamin C, Hyperthermia and More for Stage 4 Prostate Cancer (2025): A Simulated Randomized Controlled Trial
Abstract Background: Stage 4 prostate cancer has a 5-year survival rate of 37% with standard of care (SOC, e.g., androgen deprivation therapy [ADT], chemotherapy, Lu-177-PSMA-617). An optimized intervention combining repurposed drugs, supplements, diet/lifestyle, hyperthermia, and SOC components may improve outcomes. Methods : We simulated a double-blind RCT with 1,000 patients (500 per arm) with non-BRCA-mutated stage 4 prostate cancer (70% mHSPC, 30% mCRPC), comparing an integrative multimodal intervention arm (ivermectin 1.0–1.5 mg/kg/day (cycled 3 weeks on/1 off), mebendazole 500–1,500 mg/day (titrated), metformin 1,700 mg/day, vitamin C 1 g/kg IV 3 times/week, vitamin D 5,000 IU/day, curcumin 1,000 mg/day, low-glycemic Mediterranean diet, exercise, MBSR, hyperthermia [modulated electro-hyperthermia at 42°C for 60 minutes, 2–3 times weekly], plus ADT/Lu-177-PSMA-617) to a placebo arm with SOC. Primary endpoint was overall survival (OS); secondary endpoints included progression-fre...