Background: CAS was 44% successful as salvage monotherapy (Rx) of IA. We studied if CAS combined (comb) with poylenes/triazoles can improve efficacy. Data on first 30 patients (pts) enrolled in a comb study of CAS & other antifungals as salvage Rx are available. Methods: Adults with proven/probable IA (per EORTC/MSG criteria), R or I to standard Rx, received CAS 70 mg/d & >1 other antifungal. Efficacy was based on signs, symptoms & radiographs. Favorable responses (complete/partial) required significant overall improvement. Diagnoses & outcomes were assessed by an independent expert. Results: 30 pts with IA had >1d of comb Rx. Underlying diseases were AML (47%), ALL (10%), CLL/lymphoma (17%), & other hematological conditions (17%). Allo (20%) & auto (10%) HSCT & neutropenia (57%) were common. Sites were lung (80%), disseminated (17%) & sinus (3%). 24 (80%) were R & 6 (20%) were I of prior Rx. Success at end of comb Rx (EOCT) was 57%.[Table1] Success in pts with >7d of comb Rx was 70% (16/23). 47% (8/17) with neutropenia & 56% (5/9) with HSCT (3/6 allo, 2/3 auto) responded. Comb Rx for 1-71 (mean 25) d was well tolerated. 1 (3%) serious drug-related (DR) AE (hypernatremia) was noted. No pt discontinued CAS due to DRAE. Conclusion: These data suggest promise for comb Rx with CAS as salvage Rx of IA.
Full conference title:
44th Interscience Conference on Antimicrobial Agents and Chemotherapy
- ICAAC 44th