Cidara prepping for phase III rezafungin trial in bone marrow transplant patients

SAN DIEGO – New data from Cidara Therapeutics Inc. suggest the potential of its antifungal echinocandin rezafungin to prevent invasive fungal infections in bone marrow transplant (BMT) patients.

While data presented at the American Society of Hematology meeting focused on dose selection, the company's big picture goal is to head off life-threatening fungal infections. Fungal infections are a leading cause of morbidity and mortality among immunocompromised patients, particularly those undergoing BMT.

Such infections typically are treated today with either an azole antifungal to prevent Candida and Aspergillus infections and with Bactrim (trimethoprim/sulfamethoxazole, Roche Holding AG) to prevent pneumocystis, Cidara's chief medical officer, Taylor Sandison, told BioWorld.

Bactrim is "very effective in preventing pneumocystis but causes a lot of problems with myelosuppression," or depression of blood cell counts, he said. "So you can imagine that in a population that's getting a bone marrow transplant, that's not really a great toxicity to have."

Other issues, such as drug-drug interactions encountered with azoles, can also hamper care.

The goal for Cidara's San Diego-based team, he said, is to "clean up" the safety issues and replace the two-drug regimen with a single drug that's dosed once weekly. To prove it can accomplish that, the company is poised to start a phase III prophylaxis trial of rezafungin in patients undergoing allogeneic bone marrow transplantation in the first quarter of 2019.