COC Protocol (Care Oncology)

Key Components

• Metformin (500–2000 mg/day) — AMPK activator, reduces glucose/insulin, inhibits mTOR and mitochondrial Complex I
• Atorvastatin (40–80 mg/day) — HMG-CoA reductase inhibitor, disrupts mevalonate pathway cancer cells rely on for membrane synthesis
• Doxycycline (100–200 mg/day) — broad-spectrum antibiotic that selectively targets mitochondrial ribosomes in cancer stem cells
• Mebendazole (100–200 mg/day) — antiparasitic that disrupts tubulin polymerisation in cancer cells (similar mechanism to taxane chemotherapy)
• All 4 drugs taken daily alongside standard-of-care oncology treatment
• Dietary support: low-carbohydrate, low-sugar diet to amplify Metformin and Atorvastatin effects

How It Works

Each drug targets a distinct cancer vulnerability: Metformin activates AMPK (cellular energy sensor), starving cancer cells of glucose and blocking mTOR — a key growth signal. Atorvastatin blocks the mevalonate pathway, disrupting cholesterol and isoprenoid synthesis that cancer cells need for rapid membrane production, RAS protein signalling, and cell division. Doxycycline inhibits mitochondrial protein synthesis at the 70S ribosome (found in mitochondria and bacteria but not cytoplasmic ribosomes) — cancer stem cells are particularly mitochondria-dependent. Mebendazole binds tubulin and prevents microtubule polymerisation, blocking mitosis (cell division) in cancer cells. Together they attack energy metabolism, lipid synthesis, cancer stem cell survival, and cell division simultaneously — making it very difficult for cancer to adapt and resist.

The strongest evidence is for glioblastoma (GBM): the METRICS trial (Care Oncology Clinic, 2020) showed patients on COC + standard treatment had significantly longer progression-free and overall survival compared to matched controls. Epidemiological data for Metformin is extensive — large population studies show diabetic patients on Metformin have 30–40% lower cancer mortality. Atorvastatin use is associated with reduced recurrence in breast, colon, and prostate cancers across multiple retrospective studies. Mebendazole has shown activity in colon, brain, and lung cancers in early-phase trials. Doxycycline's role in targeting cancer stem cells is supported by in vitro and early clinical data. A COC patient registry of 1,000+ patients is ongoing. No large RCTs yet — evidence is preliminary-to-moderate overall, strongest for GBM and breast cancer.

• Requires a doctor's prescription — never self-prescribe Metformin, Atorvastatin, Doxycycline, or Mebendazole
• Metformin: contraindicated in kidney impairment (eGFR <30), liver disease, and before IV contrast scans; can cause lactic acidosis
• Atorvastatin: monitor liver enzymes; rare risk of myopathy/rhabdomyolysis; interacts with many drugs including some antiretrovirals
• Doxycycline: photosensitivity (use sunscreen), oesophageal irritation (take upright with water), not for pregnancy or children under 8
• Mebendazole: generally very well tolerated at low doses; high doses may affect liver — monitor LFTs
• Mebendazole brands vary significantly — Emverm or Vermox are preferred; some versions have poor bioavailability
• Do not combine Metformin + IV contrast dye without pausing (48 hrs before/after) — kidney risk
• Tell your oncologist before starting — some combinations may interact with specific chemotherapy drugs
• Discuss with a COC-trained or integrative oncologist for cancer-type-specific dosing guidance