title: Second-line treatment in invasive mould infections.
abstract: A prevalence of up to 30% of invasive fungal infections (IFI) has been reported from autopsy studies in patients treated for haematological malignancies. Despite substantial advances in the last decade, IFI are still associated with a mortality of up to more than 70%, in particular for those patients suffering from invasive aspergillosis. Some progress has been made in diagnostics with the advent of new non-culture based tools and the improvement of imaging techniques. However, the response rates are about 40-60% in the first-line treatment of IFI. Salvage therapy will be necessary for those being intolerant or refractory towards the respective first-line antifungal. Following a long period of stagnation, there has been a considerable progress during the last five years in the treatment of refractory IFI. This review highlights the new treatment options for the salvage setting in the context of the state-of-the-art management of IFI in cancer patients.
authors.affiliation: Medizinische Klinik II, Onkologie und Palliativmedizin, Evangelisches Krankenhaus Bielefeld, Med. Klinik Hämatologie/Onkologie und Palliativmedizin im Johannesstift, Bielefeld, Germany. meinolf.karthaus@evkb.de
authors.forename: Meinolf
authors.initials: M
authors.lastname: Karthaus
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Cornely
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy; D006801:Humans; D009181:Mycoses / Q000188:drug therapy*; D016879:Salvage Therapy; D016896:Treatment Outcome; D014230:Triazoles / Q000627:therapeutic use*; D020096:Zygomycosis / Q000188:drug therapy
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole