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The Feasibility of Ibrexafungerp for the Treatment of Fungal Infections in Patients with Hematological Malignancies

Invasive fungal diseases (IFD) remain a major cause of morbidity and mortality in hematological patients, especially those undergoing hematopoietic stem cell transplantation (HSCT). Despite relatively high incidence, diagnosis and treatment remain a challenge due to non-specific manifestation and li...

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Autores principales: Daraskevicius, Justinas, Petraitis, Vidmantas, Davainis, Linas, Zucenka, Andrius
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144376/
https://www.ncbi.nlm.nih.gov/pubmed/35628696
http://dx.doi.org/10.3390/jof8050440
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author Daraskevicius, Justinas
Petraitis, Vidmantas
Davainis, Linas
Zucenka, Andrius
author_facet Daraskevicius, Justinas
Petraitis, Vidmantas
Davainis, Linas
Zucenka, Andrius
author_sort Daraskevicius, Justinas
collection PubMed
description Invasive fungal diseases (IFD) remain a major cause of morbidity and mortality in hematological patients, especially those undergoing hematopoietic stem cell transplantation (HSCT). Despite relatively high incidence, diagnosis and treatment remain a challenge due to non-specific manifestation and limited antifungal armamentarium. A first-in-class triterpenoid antifungal ibrexafungerp that acts by inhibiting the glucan synthase enzyme in the fungal cell wall was recently approved by the USA Food and Drug Administration for the treatment of vaginal yeast infections. Preclinical data show activity against numerous fungi species, including azole- and echinocandin-resistant strains. Preliminary data from ongoing phase 3 studies in IFD have been encouraging, but the role of ibrexafungerp in hematological patients who develop fungal infections has not yet been described. Herein, we discuss the feasibility of oral ibrexafungerp-based antifungal therapy for adult patients with hematological malignancies who have either undergone HSCT or received treatment with a novel targeted therapy agent. We present four clinical cases where ibrexafungerp alone or in combination with other antifungal agents was successfully employed for the management of refractory fungal infection. We describe real-life experiences showing the potential clinical implementation of ibrexafungerp for patients with hematological malignancies for the first time, and provoke future discussion.
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spelling pubmed-91443762022-05-29 The Feasibility of Ibrexafungerp for the Treatment of Fungal Infections in Patients with Hematological Malignancies Daraskevicius, Justinas Petraitis, Vidmantas Davainis, Linas Zucenka, Andrius J Fungi (Basel) Communication Invasive fungal diseases (IFD) remain a major cause of morbidity and mortality in hematological patients, especially those undergoing hematopoietic stem cell transplantation (HSCT). Despite relatively high incidence, diagnosis and treatment remain a challenge due to non-specific manifestation and limited antifungal armamentarium. A first-in-class triterpenoid antifungal ibrexafungerp that acts by inhibiting the glucan synthase enzyme in the fungal cell wall was recently approved by the USA Food and Drug Administration for the treatment of vaginal yeast infections. Preclinical data show activity against numerous fungi species, including azole- and echinocandin-resistant strains. Preliminary data from ongoing phase 3 studies in IFD have been encouraging, but the role of ibrexafungerp in hematological patients who develop fungal infections has not yet been described. Herein, we discuss the feasibility of oral ibrexafungerp-based antifungal therapy for adult patients with hematological malignancies who have either undergone HSCT or received treatment with a novel targeted therapy agent. We present four clinical cases where ibrexafungerp alone or in combination with other antifungal agents was successfully employed for the management of refractory fungal infection. We describe real-life experiences showing the potential clinical implementation of ibrexafungerp for patients with hematological malignancies for the first time, and provoke future discussion. MDPI 2022-04-23 /pmc/articles/PMC9144376/ /pubmed/35628696 http://dx.doi.org/10.3390/jof8050440 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Daraskevicius, Justinas
Petraitis, Vidmantas
Davainis, Linas
Zucenka, Andrius
The Feasibility of Ibrexafungerp for the Treatment of Fungal Infections in Patients with Hematological Malignancies
title The Feasibility of Ibrexafungerp for the Treatment of Fungal Infections in Patients with Hematological Malignancies
title_full The Feasibility of Ibrexafungerp for the Treatment of Fungal Infections in Patients with Hematological Malignancies
title_fullStr The Feasibility of Ibrexafungerp for the Treatment of Fungal Infections in Patients with Hematological Malignancies
title_full_unstemmed The Feasibility of Ibrexafungerp for the Treatment of Fungal Infections in Patients with Hematological Malignancies
title_short The Feasibility of Ibrexafungerp for the Treatment of Fungal Infections in Patients with Hematological Malignancies
title_sort feasibility of ibrexafungerp for the treatment of fungal infections in patients with hematological malignancies
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9144376/
https://www.ncbi.nlm.nih.gov/pubmed/35628696
http://dx.doi.org/10.3390/jof8050440
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