The mechanism of action is purported to be via mTOR pathway inhibition (Jawad and Richardson, 2023, Nunes and Ricardo, 2024, Zhang et al., 2020) which is intriguing, as this is a pathway that has been targeted in both endometrial cancers and perivascular epithelioid cell tumors (PEComas) (Slomovitz et al., 2022, Wagner et al., 2021) Ivermectin has also been shown to block PAK1, an oncogenic kinase, in human ovarian cancer and NF2-deficient Schwannoma cell lines to suppress PAK1-dependent growth in cell culture (Hashimoto et al., 2009). The gene discussed is NF2; the disease is neoplasm with perivascular epithelioid cell differentiation.