Evidence Explorer · MS-N284 · Investigational drug repurposing · Appraised November 9, 2026
A randomized multicenter trial found that adding disulfiram and copper to chemotherapy for recurrent glioblastoma increased serious toxicity without improving survival.
Evidence at a glance
- Population: 88 adults at first recurrence of glioblastoma.
- Intervention: standard alkylating chemotherapy with disulfiram 400 mg/day plus copper 2.5 mg/day versus chemotherapy alone.
- Primary result: six-month survival 44% with disulfiram/copper versus 62% with standard care (P=.10); median overall survival 5.5 versus 8.2 months.
- Evidence label: randomized negative evidence with increased harm.
What was studied
The open-label phase II/III trial randomized 43 participants to disulfiram/copper and 45 to standard care across nine Scandinavian sites.
Grade 3 or higher adverse events occurred in 34% versus 11%, serious adverse events in 41% versus 16%, and 24% stopped disulfiram because of adverse effects. A later phase I/II study in newly diagnosed disease found limited efficacy and did not reverse the randomized result.
What this evidence cannot establish
Preclinical anticancer activity and isolated molecular subgroups cannot establish benefit. The trial does not assess disulfiram’s approved use for alcohol-use disorder; it addresses off-label cancer treatment.
Safety and practical context
Disulfiram can cause hepatitis or liver failure, neuropathy, optic neuritis and psychiatric effects. Copper adds its own toxicity and monitoring considerations.
Even small alcohol exposures—including some medicines or products—can provoke flushing, vomiting, hypotension, arrhythmia, cardiovascular collapse or death during and for up to two weeks after disulfiram.
Questions for the care team
- What randomized evidence supports disulfiram for my tumor and molecular subtype?
- How will liver tests, neurologic symptoms and copper exposure be monitored?
- Which medicines, foods or topical products could contain alcohol?
Sources and identifiers
- Randomized recurrent-glioblastoma trial — PMID 37000452
- Phase I/II newly diagnosed glioblastoma study — PMID 38768767
- Current US disulfiram prescribing information
Funding and conflicts: The randomized trial received noncommercial research support; detailed sponsor roles and investigator conflicts are reported in the original article.
Source access and dates: Original reports, registry records and official safety sources available through the links above were checked November 9, 2026. Last literature search November 9, 2026.
Educational evidence summary, not individualized medical advice. Investigational or repurposed products should not replace established cancer treatment. Symptom, biomarker, laboratory or animal findings do not establish tumor control, recurrence prevention or longer survival.
