Effectiveness of antifungals decreased by oncology drugs

Little is currently known about the direct agonistic and antagonistic interactions between antifungals and other drug treatments. This is however a vital area of research, considering the high mortality rates and increasing occurrence of invasive fungal infections in patients undergoing treatments for diseases such as cancer. Invasive fungal infections can be life-threatening complications in patients with compromised immune systems, which can occur as a result of both the disease and drug treatments for cancer. Thus, a recent study has explored the antagonistic effects of several oncology treatments, when administered alongside antifungal drugs.

Initially, a library of oncology drugs was screened for any that were recorded to interfere with the antifungal activity of either azoles or echinocandins, the 2 most widely used classes of systemic antifungals. 21 compounds from a library of 129 were identified, suggesting that this type of drug-drug interaction is more common than previously expected. A number of these compounds were then tested against Candida albicans, Candida glabrata and Aspergillus fumigatus, which were grown in the presence of antifungals. Using this technique, several oncology treatments were identified as antagonising the antifungal activity and enhancing fungal growth. Additionally, common drug classes suggest that certain antagonistic interactions may be due to similarities in their mechanisms of action. 

This study throws up many questions for future research and may be key to discovering why mortality rates for many fungal infections are so high.