Administering oral ivermectin to a patient with stage 4 liver cancer (advanced hepatocellular carcinoma, HCC) involves weighing potential benefits against significant risks.

Potential Benefits

1. Anti-Cancer Properties: Ivermectin has demonstrated potent anti-cancer activities, particularly in hepatocellular carcinoma. Studies have shown that ivermectin can inhibit tumor growth, metastasis, and cancer stem cell functions by targeting multiple oncogenic pathways, such as the mTOR/STAT3 pathway[1][4].
2. Synergistic Effects with Sorafenib: Ivermectin has been found to work synergistically with sorafenib, a standard treatment for advanced HCC. This combination has shown enhanced efficacy in inhibiting tumor growth and improving survival rates in preclinical models[1][4].

Potential Risks

1. Liver Toxicity: Ivermectin is metabolized by the liver, and there have been reports of liver toxicity, including acute liver injury. For patients with stage 4 liver cancer, whose liver function is already severely compromised, the risk of exacerbating liver damage is significant[2].
2. Limited Clinical Evidence: While preclinical studies are promising, there is a lack of substantial clinical evidence demonstrating the safety and efficacy of ivermectin in treating advanced HCC in humans. The transition from laboratory results to clinical effectiveness remains unproven[3].

Conclusion

Given the potential for liver toxicity and the already compromised liver function in stage 4 liver cancer patients, the use of oral ivermectin should be approached with caution. It may offer benefits, particularly in combination with sorafenib, but these potential advantages must be carefully weighed against the significant risks. Any decision to use ivermectin should be made by a healthcare professional who can closely monitor the patient’s condition and adjust treatment as necessary.

Sources [1] Ivermectin synergizes sorafenib in hepatocellular carcinoma via … https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9107598/ [2] Ivermectin, a potential anticancer drug derived from an antiparasitic … https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505114/ [3] No, ivermectin isn’t being withheld as cancer ‘cure’ - AP News https://apnews.com/article/fact-check-ivermectin-nih-cancer-cure-629592291079 [4] Ivermectin synergizes sorafenib in hepatocellular carcinoma via … https://pubmed.ncbi.nlm.nih.gov/35568994/ [5] Ivermectin, a potential anticancer drug derived from an antiparasitic … https://www.sciencedirect.com/science/article/abs/pii/S1043661820315152 [6] Ivermectin converts cold tumors hot and synergizes with immune … https://www.nature.com/articles/s41523–021–00229–5 [7] Liver Cancer’s Metabolism Offers a New Treatment - Penn Medicine https://www.pennmedicine.org/news/news-releases/2022/august/liver-cancer-supercharged-metabolism-offers-a-new-treatment-strategy-penn-study-suggests