Emergence of Azole Therapy for Cancer Associated Fungal Infections and Their Potential Human Toxicity

Presently, azoles have emerged as excellent antifungal agents. Their broad-spectrum activity and ability to treat superficial as well as invasive infections have gained them incredible repute in antimicrobial therapy. Azoles inhibit the synthesis of ergosterol in fungi, which is important for maintaining the cell wall. This review briefly portrays the relevance of azoles in treating cancer linked fungal infections like candidiasis and aspergillosis. First generation azoles like itraconazole and fluconazole are preferred over other drugs like amphotericin B. Newer azoles (triazoles like voriconazole, posaconazole and ravuconazole) have been synthesized to oust the earlier varieties by being more potent and active against resistant organisms. Patients with lymphoma or leukemia undergoing chemotherapy or stem cell transplantation have weak immune status which makes them susceptible hosts of fungal infections. Azoles are used currently for antitumor therapy because of their specificity towards human cytochrome P-450 dependent enzymes which synthesize cholesterol. This review also attempts to point out how their applications in prostate cancer and breast cancer therapy are indispensable. But along with its advantages, it is necessary to look into the sinister role it plays in creating toxic side effects for patients. Disruption of the endocrine functioning and hepatotoxicity result in manifestations like vomiting, nausea and fatigue. Even though these complications are reversible, the full-fledged practicability of these drugs in cancer treatment is yet to be considered.