Investigational Antifungal Agents for Invasive Mycoses: A Clinical Perspective.

Treatment of invasive fungal infections (IFIs) remains challenging, because of the limitations of the current antifungal agents (ie, mode of administration, toxicity, and drug-drug interactions) and the emergence of resistant fungal pathogens. Therefore, there is an urgent need to expand our antifungal armamentarium. Several compounds are reaching the stage of phase II or III clinical assessment. These include new drugs within the existing antifungal classes or displaying similar mechanism of activity with improved pharmacologic properties (rezafungin and ibrexafungerp) or first-in-class drugs with novel mechanisms of action (olorofim and fosmanogepix). Although critical information regarding the performance of these agents in heavily immunosuppressed patients is pending, they may provide useful additions to current therapies in some clinical scenarios, including IFIs caused by azole-resistant Aspergillus or multiresistant fungal pathogens (eg, Candida auris, Lomentospora prolificans). However, their limited activity against Mucorales and some other opportunistic molds (eg, some Fusarium spp.) persists as a major unmet need.

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Déclaration de conflit d'intérêts

Potential conflicts of interest. F. L. has received research grants from the Swiss National Science Foundation, the Santos-Suarez Foundation, Novartis, Pfizer, and Merck and has participated on advisory boards for Gilead and Pfizer. R. E. L. has received research grants from Merck and Gilead; has participated on advisory boards for Gilead and Cidara therapeutics; and reports consulting fees from Cidara Therapeutics and F2G Therapeutics. D. P. K. has received research support from Astellas, Merck, T2 Biosystems, Pfizer, and Gilead and honoraria from Merck, Astellas, Gilead, and Cidara; serves on data review committee for Cidara, Scynegis, and AbbVie; and has received consulting fees from Amplyx, Scynexis, Jazz Pharmaceuticals, and Gilead. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.