Drug development challenges and strategies to address emerging and resistant fungal pathogens

ABSTRACT

Introduction: Invasive fungal infections represent an expanding threat to public health. The recent emergence of Candida auris, which is often resistant to existing antifungal agents and is associated with a high mortality rate, underscores the urgent need for novel drug development strategies.

Areas covered: In this paper, we examine both challenges and opportunities associated with antifungal drug development and explore potential avenues to accelerate the development pipeline, including data sharing, surrogate endpoints, and the role of historical controls in clinical trials.

Expert commentary: We review important lessons learned from the study of other rare diseases, including mitochondrial storage diseases and certain forms of cancer that may inform strategies to develop new antifungal agents while highlighting promising new compounds such as SCY-078 for the treatment of invasive fungal infections.

KEYWORDS:

• Echinocandin
• isavuconazole
• mycoses
• triazole
• polyene
• trialist
• immunocompromised

Declaration of interest

M. W. McCarthy has served as a paid consultant to Allergan. T. J. Walsh receives research grants for experimental and clinical antimicrobial pharmacotherapeutics from Astellas, Cubist, Theravance, the Medicines Company, Allergan, Novartis, Merck, and Pfizer; has served as a consultant to Astellas, Actavis, ContraFect, Drais, iCo, Novartis, Pfizer, Methylgene, SigmaTau, and Trius. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.