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The antifungal pipeline for invasive fungal diseases: what does the future hold?
Chin Fen Neoh1,2,3, Wirawan Jeong4, David Cm Kong5,6,7,8
1National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia.
Introduction:
Over the last two decades, we have experienced pressing needs for new additions to the antifungal armamentarium given the emergence of resistant fungi, the growth of at-risk patient populations for invasive fungal diseases (IFD), the high morbidity and mortality associated with IFD.
Areas Covered:
The current review will discuss the five promising antifungal agents for IFD (i.e. fosmanogepix, ibrexafungerp, olorofim, rezafungin, and opelconazole), now in the late-phase clinical studies, and likely to be available for clinical use in the near future. For each agent, we describe its mechanism of action, pharmacokinetic and pharmacodynamic properties, spectrum of activity as well as the safety and efficacy data, including findings from ongoing clinical trials. The potential roles of these novel antifungals in clinical practice and the key considerations for clinical use will also be discussed.
Expert Opinion:
There are unmet needs of these novel agents that should be addressed in the future studies. These include defining their indications and benefits, how to best target them appropriately, surveillance and stewardship of their use.
Insights
New antifungal drugs are crucial for combating resistant fungi and invasive fungal diseases (IFD). This review covers five promising agents in late-stage trials, detailing their properties and clinical potential.
Area of Science:
- Infectious Diseases
- Mycology
- Pharmacology
Background:
- Rising incidence of invasive fungal diseases (IFD).
- Emergence of antifungal resistance.
- Increased population at risk for IFD.
Approach:
- Review of five novel antifungal agents in late-phase clinical studies.
- Detailed analysis of each agent's mechanism of action, pharmacokinetics, pharmacodynamics, spectrum of activity, safety, and efficacy.
- Discussion of clinical applications and considerations for novel antifungals.
Key Points:
- Fosmanogepix, ibrexafungerp, olorofim, rezafungin, and opelconazole are promising new antifungal agents.
- These agents target critical pathways in fungal pathogens.
- Clinical trial data indicate favorable safety and efficacy profiles.
Conclusions:
- Novel antifungals are expected to expand treatment options for IFD.
- Further research is needed to define optimal use, indications, and stewardship strategies.
- These agents hold significant promise for improving outcomes in patients with IFD.
