The development of new antifungal continues with several tracks. The first track is to develop new molecules in known classes of antifungal (1). Among the triazoles, the isavuconazole is already in phase 3 evaluation, the albuconazole is less advanced. Among the echinocandins, currently number three (caspofungin, Micafungin and anidulafungin), a new molecule is under consideration, the aminocandin. From polyenes, a liposomal formulation of nystatin is under investigation. This work on antifungal classes already recognized aim is to broaden the spectra, which is often limited when the mode of action remains similar, or, and this is the most frequent ambition to improve pharmacokinetics, bioavailability and reduce the toxicity. The development of long half-life products allows to consider improvements to the prescription at the patient level. In parallel, new routes of administration are evaluated, like liposome aerosol amphotericin B (2).
Meanwhile a more upstream research aims to validate new classes of antifungal. The FG3409 is a novel small molecule whose development is already advanced enough (3). One can also cite the combination of a known molecule, amphotericin B, with anti-HSP90 antibody, some publications underline the interest for the treatment of candidemia (4).
The availability of new antifungal different classes relaunched clinical research on associations whose clinical validation is expected.
Full conference title:
- RICAI 28th (2008)