A study looking at antifungal drugs for people with advanced cancer

Cancer type:

All cancer types

Status:

Results

Phase:

Phase 1

This study looked at antifungal treatments for people with advanced cancer Open a glossary item .

People with cancer are more at risk of developing an infection. This may be due to their disease or treatment of their cancer. A type of fungal (or yeast) infection of the mouth, known as thrush, is common in people with cancer.

Thrush is normally treated by keeping the mouth clean and moist and with antifungal treatments, such as fluconazole. Studies have suggested that some of these infections have become resistant to treatment with some antifungal drugs. This means that the treatment no longer works. This resistance may be caused by the increased use of antifungal drugs.

The aims of this study were to

Find out if resistance to antifungal drugs was common in people with advanced cancer
Look at possible factors that lead to resistance to these types of drugs

Summary of results

The researchers prepared a summary of this study in 2008 for the Department of Health.

390 people with advanced cancer took part in this study. The researchers found

7 out of 10 people (70%) had yeast present in their mouth
About 1 in 8 people (13%) actually had a yeast infection

There are different groups of antifungal drugs, such as polyenes (for example nystatin) and azoles (for example fluconazole). The researchers found that resistance to the azole group of drugs was quite common, particularly with fluconazole which is used most often. It was uncommon for there to be resistance to the polyene drugs.

People who were resistant to azole drugs had not necessarily had the drugs before. The researchers did find a link between resistance and areas of the country that had highest use of these drugs in the general population. They also found that drug resistance was more common in people with the type of yeast which causes thrush. People who had a very dry mouth (xerostomia) were more likely to have thrush.

From this study, the researchers made several suggestions;

By treating people with a very dry mouth doctors may prevent thrush from developing. So antifungal drugs won’t need to be used as much
To think about limiting some of the use of antifungal drugs in the general population
Further research is needed to learn more about this, and to look into other treatments for fungal infections in the mouth

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) but may not have been published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.