Father, husband, and radiation oncologist | Assistant Professor @PennStateHershey | former resident @yaleradonc | Pitt Panther fan (H2P)

Joined September 2018
20 Photos and videos
Joseph A. Miccio, MD retweeted
This preprint reports "high clinical benefit" of ivermectin mebendazole in cancer patients. However, the study authors themselves state 'benefit cannot be inferred' due to design limitations. Let's unpack why.
🚨BREAKING: Largest Real-World Study of Ivermectin Mebendazole in Cancer Patients Shows 84.4% Clinical Benefit — Nearly HALF Report Cancer Disappearance or Tumor Regression After just 6 months, 48.4% of cancer patients taking ivermectin and mebendazole reported NO EVIDENCE OF DISEASE (32.8%) or tumor regression (15.6%), while 36.1% reported disease stabilization⬇️ We have completed the largest real-world human analysis to date evaluating ivermectin and mebendazole in cancer patients—and the results represent one of the most compelling clinical signals ever documented for repurposed anti-parasitic therapies in oncology. The groundbreaking analysis was made possible through a unique collaboration between The Wellness Company, the McCullough Foundation, and the Chairman of the President’s Cancer Panel (Dr. Harvey Risch)—uniting real-world clinical data, frontline medical experience, and high-level epidemiologic expertise to deliver urgently needed insights in oncology. This was a real-world prospective clinical program evaluation of 197 cancer patients, with 122 completing a follow-up survey at about six months (61.9% response rate). Cancer patients were prescribed compounded ivermectin–mebendazole, with each capsule containing 25 mg ivermectin and 250 mg mebendazole—most commonly taken at 1–2 capsules per day. The cohort represented a clinically relevant population, including a wide variety cancer types, with 37.1% of patients reporting actively progressing disease at baseline and many having already undergone chemotherapy, radiation, and surgery. At six months, 84.4% of cancer patients reported clinical benefit (Clinical Benefit Ratio: 84.4% [95% CI: 77.0–89.8%]): ✅ 32.8% reported no evidence of disease (95% CI: 25.1–41.5%) ✅ 15.6% reported tumor regression (95% CI: 10.2–23.0%) ✅ 36.1% reported stable disease (95% CI: 28.1–44.9%) Treatment adherence was high, with 86.9% completing the full protocol and 66.4% remaining on therapy at six months. The regimen was well tolerated, with 25.4% reporting side effects, primarily mild and gastrointestinal, and over 93% continuing treatment despite these events. Patients were treated in real-world conditions alongside concurrent therapies, including chemotherapy (27.9%), radiation (21.3%), surgery (19.7%), supplements (49.2%), and dietary modification (37.7%), supporting use as an adjunctive approach. Together, these findings represent a large, internally consistent real-world clinical signal that supports URGENT further investigation of ivermectin and mebendazole as low-toxicity, adjunctive cancer therapies. Given the strength of the signal observed here, advancing this line of investigation is no longer optional—it is necessary. This is NOT the end. We will continue advancing this work with larger datasets to further define and validate the role of anti-parasitics in cancer outcomes. The manuscript is now available as a preprint on the Zenodo research repository, operated by the European Organization for Nuclear Research, while undergoing peer review at leading oncology journals: “Real-World Clinical Outcomes of Ivermectin and Mebendazole in Cancer Patients: Results from a Prospective Observational Cohort.” @twc_health @McCulloughFund @P_McCulloughMD @DrHarveyRisch @DrKellyVictory @jathorpmfm @drdrew @PeterGillooly @FosterCoulson
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Joseph A. Miccio, MD retweeted
🚨You asked and we delivered - CURB2 Ph3 RCT now allows those assigned to SOC to have the flexibility to stay on same systemic therapy➡️real world practice. Please consider opening/accruing this trial🙏 @NRGonc @CDNCancerTrials @DrMengWelliver
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Joseph A. Miccio, MD retweeted
We’re hiring! Radiation Oncologist opportunity at Penn State Health Join a growing, collaborative team delivering cutting-edge, patient-centered cancer care across a leading academic health system. 👉 Apply here: pennstatehealth.org/careers/…
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Joseph A. Miccio, MD retweeted
Pleased to share our recently published ASTRO consensus paper in Practical Radiation Oncology on DVH dose constraints for radiation therapy treatment planning, led by my friend Dr. Lindsay Puckett. practicalradonc.org/article/… A thread on the goals of this effort 🧵 #RadOnc #ASTRO
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Joseph A. Miccio, MD retweeted
Localized prostate cancer management is NOT one-size-fits-all. 🎯 From low-risk to very high-risk and cN1 disease, treatment decisions hinge on risk stratification, imaging, and timing of ADT. These guideline algorithms bring clarity to: 🟢 Active surveillance vs radical treatment 🟡 Favorable vs unfavorable intermediate risk 🔴 High-risk, very high-risk, and cN1 disease 🔁 Post-treatment PSA monitoring and salvage pathways 📸 BCR workup with PSMA PET-CT and MRI 📘 Evidence-based. Structured. Practical. 🔖 Save for clinics 📤 Share with your unit @myesmo @esmo_open @OncoAlert @ASCO @ASTRO_org #OncoTwitter #MedTwitter #ProstateCancer #UroOnc #RadiationOncology #MedicalOncology #GUOncology
Localised prostate cancer just changed. Again. ESMO 2026 brings clarity on who to observe, who to escalate, and which trials actually matter 👇 🧠 Diagnosis MRI before biopsy is standard High-resolution US is a valid alternative (RCT n=678) 🧭 Low risk Active surveillance is safe ProtecT 15-yr data shows similar survival vs RP/RT ☢️ Radiotherapy Shorter is better CHHiP ➜ moderate hypofractionation HYPO-RT-PC ➜ ultra-hypofractionation PACE-B ➜ SBRT works in selected IR disease 📈 High risk RT long-term ADT saves lives SPCG-7 | NCIC/MRC Dose escalation improves OS (GETUG-AFU 18) 🚨 Very high-risk / cN1 RT ADT abiraterone is the new benchmark STAMPEDE delivers MFS OS benefit 🔁 Biochemical recurrence Avoid routine adjuvant RT Early salvage RT preferred RADICALS-RT | RAVES | GETUG-AFU 17 High-risk BCR? Intensify EMBARK supports enzalutamide ADT 🧠 Bottom line Risk-adapted care > overtreatment Imaging-driven decisions Escalate only when trials prove benefit 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #ProstateCancer #GUOncology @OncoAlert @myesmo @esmo_open @asco @OncBrothers
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Joseph A. Miccio, MD retweeted
Ever had a case of spurious postop PSA elevation that didn’t make sense? Hint: recheck the PSA with human anti-mouse antibody (HAMA) treatment. Here’s a case where a patient was spared from unnecessary salvage therapy.
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Joseph A. Miccio, MD retweeted
☢️New meta-analysis in JAMA Network Open: 🎯Stereotactic body radiotherapy (SBRT) alone for oligometastatic cancer achieved 70% systemic therapy-free survival at 1-2 years, highest in renal (87%) and prostate cancer (78%). 🎯Low toxicity rates suggest SBRT may safely defer chemotherapy in selected patients. 10.1001/jamanetworkopen.2025.49685 @OncoAlert @DrYukselUrun #MedX #Cancer #Oncology @JAMANetworkOpen
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Joseph A. Miccio, MD retweeted
The Oakland Zoo used to be one of the best student sections in the country. Take a moment to watch the pregame before the Syracuse game in 2011.
Replying to @RetroPitt
People that don't know will just never know. It was one of the greatest atmospheres in all of college basketball. I was at the games yet I taped them on my VCR to watch again when I got home. There was literally nothing like being there. It's embarrassing now.
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Joseph A. Miccio, MD retweeted
left ‘em in (Reese’s) pieces 😼🫨🍫 @Pitt_MBB DOMINATES penn state 80-46‼️‼️‼️
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Joseph A. Miccio, MD retweeted
17 Dec 2025
Don’t want to just data dump a bunch of kidney SBRT papers on ya rn (sorry I am enthusiastic about this topic) but in general even for niche solitary kidney scenarios fantastic results median eGFR decline around 13 ml/min plateaus at 2 years so it’s a fantastic option especially for peri-hilar or > 2-3 cm not suitable for thermal ablation as most patients motivated to avoid HD, also associated with 99% 5y local control
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Joseph A. Miccio, MD retweeted
Proud of our Radiation Oncology team for giving back to our community. Together, we donated 141 lbs of food to the Hershey Food bank—helping support families in need and making a meaningful impact beyond the clinic. @PennStHershey
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Joseph A. Miccio, MD retweeted
Here are all the oligomets RCTs. HRs < 1 in green. @Mat_Guc
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Joseph A. Miccio, MD retweeted
🎗️October is Breast Cancer Awareness Month. Radiation treatment is more than a therapy - it's a step toward healing and renewed hope. Every beam is aimed at a future free from cancer. To everyone walking this path; your strength inspires us all. 💗@PennStHershey
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Joseph A. Miccio, MD retweeted
📢 Excited to welcome @VinitaTakiar, the new Chair of the Department of Radiation Oncology! We’re excited for the leadership, expertise, and vision Dr. Takiar brings to our team. #Welcome #RadOnc @PennStHershey
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Joseph A. Miccio, MD retweeted
18 May 2025
🧵1/ 🚨New case report out in Cureus: Face the Pain: Radiobiological and Clinical Considerations of Re-radiosurgery to the Trigeminal Nerve 👉 A deep dive into a unique case of medically refractory TGN in the setting of a petroclival meningioma. 🔗 doi.org/10.7759/cureus.84281
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Joseph A. Miccio, MD retweeted
Interested in an updated overview of small cell lung cancer geared towards a general audience? Check out our review article published in JAMA! @Sokim_33 @Annechiangmd @YaleMed @YaleCancer @YaleRadOnc
31 Mar 2025
Small cell lung cancer (SCLC) is a smoking-related malignancy that presents at an advanced stage in 70% of patients. This narrative review summarizes the epidemiology, molecular characteristics, clinical presentation, and management of SCLC. ja.ma/4j5YgRF
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Joseph A. Miccio, MD retweeted
Epidural spinal cord compression (ESCC) scale for cancer metastasis
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Joseph A. Miccio, MD retweeted
🚨🔥 1/2 @OncoAlert Hot off the press. Just published @NEJM in conjunction with presentation on updated data @myESMO #ESMO2024 Results of #ADRIATIC trial of #Durvalumab vs #Placebo after #Chemoradiotherapy in Limited-Stage #SmallCell #LungCancer. 👇🏼 nejm.org/doi/full/10.1056/NE…
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Joseph A. Miccio, MD retweeted
🚨Check out this editorial!🚨 “Personalizing Treatment Decisions for Locally Advanced Rectal Cancer to Balance Quality of Life, Function, and Cancer Control” @ASCOPost @ASCO @KarynAGoodman @EricDozoisMD @MayoRadOnc @QuadShotNews @ACROresident #CRC brnw.ch/21wO4pn
24 Oct 2024
There has been a dramatic transformation of care for pts w locally advanced #RectalCancer w overarching goal to better balance disease control w long-term #QoL & function. Experts discuss treatments, recent trial data: brnw.ch/21wO4pn @KrishanJethwa #GICSM #ASCODailyNews
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Joseph A. Miccio, MD retweeted
Excited to share about NRG GI-011 (aka LAP100) – anticipated opening in mid/early 2025. In this Phase III RCT, we are assessing the benefit of dose-escalated radiotherapy in patients with locally advanced unresectable pancreas cancer. 🧵1/11
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