1. Multimodal standard of care comes first
Stage II pathways are often more complex than stage I: neoadjuvant or adjuvant sequences, node sampling, radiation fields, and biomarker-driven drugs. Your oncologist sequences these for a reason — investigational interest should not scramble that sequence.
- Confirm clinical vs pathologic stage after surgery when applicable.
- Ask which guidelines (NCCN, ESMO, national) frame your plan.
- Record all concurrent medicines before any experimental discussion.
2. Investigational IVM / FBZ / MBZ as adjunct research interest
Combination thinking appears more often in stage II–III discussions because SOC already uses multi-agent regimens. That does not mean antiparasitic repurposing is validated for stage II solid tumours.
- MBZ — human oncology signals exist in other settings (HGG phase I with TMZ; small mCRC RCT with FOLFOX/bev; recurrent GBM phase II with mixed endpoint result).
- IVM — ICI combination trials (TNBC, ICONIC solid tumours) illustrate the research direction of pairing with immuno-oncology, not a general stage II recipe.
- FBZ — preclinical microtubule/metabolism data and informal case narratives; formal cancer RCTs lacking.
- Real-world IVM+MBZ observation — self-reported benefit in mixed cancers is hypothesis-generating, not stage-stratified proof.
Never replace SOC
Do not stop or postpone indicated chemo, RT, surgery, immuno or targeted therapy to “run a protocol” found online.
3. Process for stage II
- Map the SOC calendar — surgery date, chemo cycles, RT start, restaging scans.
- Trial search — filter ClinicalTrials.gov by cancer type, stage, and location; ask about repurposing or immunotherapy arms.
- Oncologist questions — interactions with CYP substrates, myelosuppression, hepatotoxicity, QT, absorption with food/fat for benzimidazoles.
- Lab monitoring plan — only under clinical responsibility if any experimental use is considered.
4. Published dose ranges (study facts, not orders)
| Study / setting | Published dose fact | Link |
|---|---|---|
| Gallia 2021 · HGG + TMZ phase I | MBZ up to 200 mg/kg/day in escalation cohorts; LFT monitoring | PMC |
| Hegazy · mCRC NCT03925662 | MBZ 500 mg ×2 + FOLFOX4/bevacizumab (study arm) | NCT |
| Patil 2022 · recurrent GBM phase II | MBZ combined with CCNU or TMZ (both arms had MBZ); different disease state | DOI |
| IVM + ICI trials | Protocol doses defined per NCT; check current protocol documents | NCT05318469 |
5. Bottom line for stage II
Research framing
Multimodal oncology care remains primary. Use stage pages to structure questions and find original papers —
not to assemble unsupervised drug cocktails. Prefer registered trials when exploring repurposing.
Protocols hub ← Stage I Stage III → Studies
4. Example regimens found in literature / public protocols
Below are cited examples (trials, cases, patient protocols) — not a prescription for you. In stage I: complete curative standard care first.
| Example | Type | Published / discussed regimen | Source |
|---|---|---|---|
| MBZ — Michigan ACC | Case | Mebendazole 100 mg twice daily monotherapy after other therapy stopped; ~19 mo stability in the case | PubMed 21454232 |
| MBZ — Gallia / Hopkins HGG | Phase I | Mebendazole oral dose escalation ~25–200 mg/kg/day with temozolomide; LFTs monitored | NCT01729260 |
| MBZ — Egypt mCRC | Small RCT arm | Mebendazole 500 mg twice daily + FOLFOX4/bevacizumab | NCT03925662 |
| IVM — Cedars-Sinai TNBC | Phase I/II | Ivermectin oral 30 / 45 / 60 mg on days 1–3, 8–10, 15–17 of each 21-day cycle + ICI | NCT05318469 |
| IVM — ICONIC | Phase II | ~200 vs 400 µg/kg ivermectin + checkpoint inhibitor | NCT07487805 |
| FBZ — Tippens-style | Community | Fenbendazole often ~222 mg/day in cyclic schedules + supplements; often concurrent with other cancer therapy | ACS |
| FBZ — veterinary label | Animal label | Panacur C typically 50 mg/kg × 3 days for GI worms — not a human cancer indication | DailyMed |
Stage II reading of the table Most published human doses come from advanced disease or specialized trials — not from multimodal stage II pathways. Map of what existed in protocols, not what you “should take” after surgery.