TY - JOUR
T1 - Moving Past Ganciclovir and Foscarnet
T2 - Advances in CMV Therapy
AU - Hakki, Morgan
N1 - Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Purpose of Review: CMV DNA polymerase inhibitors such as ganciclovir and foscarnet have dramatically reduced the burden of CMV infection in the HCT recipient. However, their use is often limited by toxicities and resistance. Agents with novel mechanisms and favorable toxicity profiles are critically needed. We review recent developments in CMV antivirals and immune-based approaches to mitigating CMV infection. Recent Findings: Letermovir, an inhibitor of the CMV terminase complex, was approved in 2017 for primary CMV prophylaxis in adult seropositive allogeneic HCT recipients. Maribavir, an inhibitor of the CMV UL97 kinase, is currently in two phase 3 treatment studies. Adoptive immunotherapy using third-party T cells has proven safe and effective in preliminary studies. Vaccine development continues, with several promising candidates currently under study. Summary: No longer limited to DNA polymerase inhibitors, the prevention and treatment of CMV infections in the HCT recipient is a rapidly evolving field which should translate into improvements in CMV-related outcomes.
AB - Purpose of Review: CMV DNA polymerase inhibitors such as ganciclovir and foscarnet have dramatically reduced the burden of CMV infection in the HCT recipient. However, their use is often limited by toxicities and resistance. Agents with novel mechanisms and favorable toxicity profiles are critically needed. We review recent developments in CMV antivirals and immune-based approaches to mitigating CMV infection. Recent Findings: Letermovir, an inhibitor of the CMV terminase complex, was approved in 2017 for primary CMV prophylaxis in adult seropositive allogeneic HCT recipients. Maribavir, an inhibitor of the CMV UL97 kinase, is currently in two phase 3 treatment studies. Adoptive immunotherapy using third-party T cells has proven safe and effective in preliminary studies. Vaccine development continues, with several promising candidates currently under study. Summary: No longer limited to DNA polymerase inhibitors, the prevention and treatment of CMV infections in the HCT recipient is a rapidly evolving field which should translate into improvements in CMV-related outcomes.
KW - Antiviral
KW - Cytomegalovirus
KW - Filociclovir
KW - Hematopoietic cell transplant
KW - Letermovir
KW - Maribavir
UR - http://www.scopus.com/inward/record.url?scp=85078444470&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85078444470&partnerID=8YFLogxK
U2 - 10.1007/s11899-020-00557-6
DO - 10.1007/s11899-020-00557-6
M3 - Review article
C2 - 31981100
AN - SCOPUS:85078444470
SN - 1558-8211
VL - 15
SP - 90
EP - 102
JO - Current Hematologic Malignancy Reports
JF - Current Hematologic Malignancy Reports
IS - 2
ER -