Publication Name	World Journal of Clinical Cases
Manuscript ID	124046
DOI	10.12998/wjcc.124046
Country	United States

Category	Oncology
Manuscript Type	Correspondence
Article Title	Letter to the Editor: Fenbendazole liver enzyme elevation in checkpoint inhibitor-treated patients as benzimidazole potentiated immunogenic tumor cell death
Manuscript Source	Unsolicited Manuscript
All Author List	William Supple
Funding Agency and Grant Number
Corresponding Author	William Supple, Founder, Principal Investigator, Professor Emeritus, Department of Translational Oncology, Ben Fen Institute, Pierson Drive, Shelburne, VT 05482, United States. bill@benfeninstitute.org
Key Words	Fenbendazole; Mebendazole; Benzimidazole; Onconecrosis; Immunogenic cell death; Immune checkpoint inhibitor; Programmed cell death protein-1; Programmed cell death ligand-1; Tumor lysis
Core Tip	Benzimidazole anthelmintics directly modulate the programmed cell death protein-1/programmed cell death ligand-1 checkpoint axis and induce immunogenic tumor cell death. In cancer patients with hepatic metastases receiving concurrent immune checkpoint inhibitor (ICI), dose-escalation of fenbendazole would be expected to produce a wave of immunogenic tumor cell lysis releasing hepatic enzymes — biochemically indistinguishable from drug hepatotoxicity by currently applied metrics. The aspartate aminotransferase: Alanine aminotransferase ratio, alkaline phosphatase trajectory, lactate dehydrogenase, uric acid, and serial tumor markers are the minimum discriminating parameters required. ICI rechallenge tolerance does not prove fenbendazole causality.
Citation	Supple W. Letter to the Editor: Fenbendazole liver enzyme elevation in checkpoint inhibitor-treated patients as benzimidazole potentiated immunogenic tumor cell death. World J Clin Cases 2026; In press DOI: https://doi.org/10.12998/wjcc.124046
PDF	124046-in-press.pdf

Received	2026-06-04 02:01
Peer-Review Started	2026-06-04 02:01
First Decision by Editorial Office Director
Return for Revision	2026-07-30 02:08
Revised	2026-08-18 16:45
Publication Fee Transferred
Second Decision by Editor	2026-08-28 02:55
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-08-28 09:28
Articles in Press	2026-08-28 09:28
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2307-8960 (online)
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