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Second-line treatment in invasive mould infections
Meinolf Karthaus1, Oliver A Cornely
1Medizinische Klinik II, Onkologie und Palliativmedizin, Evangelisches Krankenhaus Bielefeld, Med. Klinik Hämatologie/Onkologie und Palliativmedizin im Johannesstift, Bielefeld, Germany. meinolf.karthaus@evkb.de
Abstract:
A prevalence of up to 30% of invasive fungal infections (IFI) has been reported from autopsy studies in patients treated for haematological malignancies. Despite substantial advances in the last decade, IFI are still associated with a mortality of up to more than 70%, in particular for those patients suffering from invasive aspergillosis. Some progress has been made in diagnostics with the advent of new non-culture based tools and the improvement of imaging techniques. However, the response rates are about 40-60% in the first-line treatment of IFI. Salvage therapy will be necessary for those being intolerant or refractory towards the respective first-line antifungal. Following a long period of stagnation, there has been a considerable progress during the last five years in the treatment of refractory IFI. This review highlights the new treatment options for the salvage setting in the context of the state-of-the-art management of IFI in cancer patients.
Insights
Invasive fungal infections (IFI) remain a significant threat in cancer patients, with high mortality rates. Recent advancements offer new hope for salvage therapy in refractory cases.
Area of Science:
- Oncology
- Infectious Diseases
- Mycology
Background:
- Invasive fungal infections (IFI) affect up to 30% of patients with hematological malignancies.
- IFI, particularly invasive aspergillosis, are associated with high mortality rates exceeding 70%.
- Current first-line antifungal treatments show response rates of only 40-60%.
Purpose of the Study:
- To review recent advancements in the diagnosis and treatment of IFI in cancer patients.
- To highlight novel treatment options for salvage therapy in refractory IFI.
- To provide an overview of the state-of-the-art management of IFI in this vulnerable population.
Main Methods:
- Literature review of recent studies on IFI diagnostics and therapeutics.
- Analysis of new non-culture based diagnostic tools and imaging techniques.
- Evaluation of emerging antifungal agents and treatment strategies for salvage therapy.
Main Results:
- Progress in diagnostic tools has improved early detection of IFI.
- New antifungal agents have shown promise in treating refractory IFI.
- Salvage therapy options have expanded significantly in the last five years.
Conclusions:
- Despite advances, IFI remain a critical challenge in cancer care.
- Novel salvage therapies offer improved outcomes for patients with refractory IFI.
- Integrated diagnostic and therapeutic strategies are crucial for managing IFI in cancer patients.
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