ICONIC: ivermectin combined with immune checkpoint inhibition in cancer (University of Florida phase 2)
A University of Florida trial will randomise 80 people already on immunotherapy to two doses of ivermectin and measure a change in their immune cells after two weeks. It is not yet open and does not measure whether tumours shrink.
Overview
ICONIC is a randomised, parallel-arm phase 2 in 80 adults with solid tumours, due to start in September 2026 and reach its primary completion in September 2027 (ClinicalTrials.gov NCT07487805). The primary endpoint is the median fold-change at week 2 in Ki-67-positive, HLA-DR-positive non-naive CD8 T cells, a laboratory marker of T-cell activation, with adverse events and cytokine changes as secondary endpoints (ClinicalTrials.gov NCT07487805). The registry text explains the rationale: widespread off-label use after public claims, a 2023 survey in Loja, Ecuador in which 19 percent of respondents had used ivermectin alongside cancer treatment, virtually absent clinical data, and a reported case of severe neurotoxicity in a patient with metastatic osteosarcoma on regorafenib attributed to a CYP3A4 interaction (ClinicalTrials.gov NCT07487805).
A reminder that ivermectin interacts with cancer drugs: the dose that a healthy adult tolerates can poison a patient whose liver enzymes are already occupied by a kinase inhibitor.
Shows how widespread use already is where cancer care is expensive, and why the ICONIC investigators cite it as a reason to run a proper trial.
This is the scientific basis for pairing ivermectin with checkpoint antibodies in the Cedars-Sinai and ICONIC trials. Its key figure is now in doubt, which makes those trials more important, not less, as the only way to find out whether the effect is real.
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