Small-Molecule Protein Kinases Inhibitors and the Risk of Fungal Infections

Katie Bechman, James B. Galloway, Kevin L. Winthrop

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations


Purpose of Review: This review discusses fungal infections associated with licenced small-molecule protein kinase inhibitors. For each major drug class, the mechanism of action and targeted pathways and the impact on host defence against fungi are described. Recent Findings: Protein kinase inhibitors are successfully used in the treatment of malignancies and immune-mediated diseases, targeting signalling pathways for a broad spectrum of cytokines and growth-stimuli. These agents predispose to fungal infections by the suppression of integral components of the adaptive and innate immune response. Summary: The greatest risk of fungal infections is seen with bruton tyrosine kinase inhibitors, e.g. ibrutinib. Infections are also reported with agents that target mTOR, Janus kinase and break point cluster (Bcr) gene–Abelson (Abl) tyrosine kinase (BCR-ABL). The type of fungal infection fits mechanistically with the specific pathway targeted. Infections are often disseminated and present soon after the initiation of therapy. The pharmacokinetic profile, possibility of off-target kinase inhibition, and underlying disease pathology contribute to infection risk.

Original languageEnglish (US)
Pages (from-to)229-243
Number of pages15
JournalCurrent Fungal Infection Reports
Issue number4
StatePublished - Dec 1 2019


  • BCR-ABL inhibitor
  • BTK inhibitor
  • Fungal infections
  • JAK inhibitor
  • Small-molecule protein kinases inhibitors
  • mTOR inhibitor

ASJC Scopus subject areas

  • Infectious Diseases


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