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Acetazolamide + levamisole is a combination of two small molecule drugs being investigated for the treatment of advanced hepatocellular carcinoma (HCC). Acetazolamide is a carbonic anhydrase inhibitor and diuretic that may exert anti-tumor effects by inhibiting the reverse TCA cycle, thereby affecting cancer cell metabolism. Levamisole is an immunomodulatory and antihelminthic agent with activity as an agonist at nematode nicotinic acetylcholine receptors; in oncology, it has been used to restore depressed immune function and enhance immune responses. The combination aims to leverage both metabolic inhibition (acetazolamide) and immunomodulation (levamisole) for potential synergistic antitumor effects in HCC[1][2].
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