Antifungal Drug Discovery & Development - Fifth International Summit. 28-29 March 2001, Princeton, NJ, USA

Reviews of recent clinical trials of marketed and investigational antifungal products revealed a number of recurring themes. There is currently a severely limited arsenal of antifungal drugs from which clinicians can choose. Many of the new products are improved versions or formulations of existing chemistries and modes of action, all of which still have some serious limitations, such as toxicity, insufficient solubility, rapid evolution of drug resistance, cost, and antagonisms when used in combination with other drug therapies. Specific sequential treatments with existing drugs appear to offer some promise, but problems in recruiting sufficient 'clean patients', who do not have many other health problems and complicated treatment histories, confounds such trials. Also, the current registration process requires the demonstration of efficacy as a single agent. Recent advances in the identification and validation of new drug targets, screening technologies and efficient exploitation of new chemistries from natural products appears to offer significant promise for the future. It will be of interest to see how quickly these advances in drug discovery result in new and improved antifungal drugs in commercial development pipelines.