Table 1.
One-Year Incidence of Invasive Fungal Infections in Patients Beginning Treatment With a Small Molecule Kinase Inhibitor—United States, July 2016–June 2019a
| SMKI | IFI Incidence, No./Total (%)b | Time to 1st IFI Diagnosis, Median, (IQR), d | Patients Hospitalized at Time of 1st IFI Diagnosis, No. (%) | IFI Types Diagnosed Within 1 y (No. of Patients) |
|---|---|---|---|---|
| Abemaciclib | 4/281 (1.4) | 44 (9–147) | 3 (75.0) | Candidiasis (2); PCP (1); not specified (1) |
| Afatinib | 5/133 (3.8) | 215 (208–257) | 1 (20.0) | Candidiasis (2); PCP (2); not specified (1) |
| Alectinib | 1/185 (0.5) | 313 (313–313) | 0 (0.0) | Aspergillosis (1) |
| Axitinib | 0/108 (0.0) | … | … | … |
| Bosutinib | 1/133 (0.8) | 134 (134–134) | 0 (0.0) | PCP (1) |
| Cabozantinib | 5/331 (1.5) | 215 (68–358) | 2 (40.0) | Candidiasis (2); coccidioidomycosis (1); not specified (2) |
| Crizotinib | 2/114 (1.8) | 143 (140–146) | 1 (50.0) | Aspergillosis (1); not specified (1) |
| Dabrafenib | 4/226 (1.8) | 265 (195–293) | 1 (25.0) | Candidiasis (2); coccidioidomycosis (1); PCP (1) |
| Dasatinib | 20/620 (3.2) | 111 (59–210) | 11 (55.0) | PCP (8); candidiasis (3); histoplasmosis (1); mucormycosis (1); not specified (7) |
| Erlotinib | 2/211 (0.9) | 16 (14–18) | 2 (100.0) | Candidiasis (2) |
| Everolimus | 22/1084 (2.0) | 109 (68–229) | 11 (50.0) | Aspergillosis (5); candidiasis (4); PCP (4); coccidioidomycosis (2); cryptococcosis (1); mucormycosis (1); not specified (6) |
| Ibrutinib | 38/1286 (3.0) | 169 (91–272) | 17 (44.7) | Aspergillosis (14); PCP (7); candidiasis (6); coccidioidomycosis (2); mucormycosis (2); cryptococcosis (1); not specified (9) |
| Imatinib | 5/902 (0.6) | 155 (23–225) | 1 (20.0) | Candidiasis (1); histoplasmosis (1); not specified (3) |
| Lapatinib | 1/150 (0.7) | 107 (107–107) | 0 (0.0) | Candidiasis (1) |
| Lenvatinib | 3/156 (1.9) | 220 (193–279) | 0 (0.0) | Candidiasis (1); not specified (2) |
| Midostaurin | 11/104 (10.6) | 131 (84–214) | 6 (54.5) | Aspergillosis (3); PCP (3); candidiasis (1); not specified (5) |
| Neratinib | 1/327 (0.3) | 325 (325–325) | 1 (100.0) | Candidiasis (1) |
| Nilotinib | 2/277 (0.7) | 56 (50–61) | 2 (100.0) | PCP (1); not specified (1) |
| Nintedanib | 6/422 (1.4) | 257 (167–279) | 2 (33.3) | Aspergillosis (2); candidiasis (1); histoplasmosis (1); coccidioidomycosis (1), cryptococcosis (1) |
| Osimertinib | 3/444 (0.7) | 234 (143–236) | 0 (0.0) | Aspergillosis (1); candidiasis (1); PCP (1) |
| Palbociclib | 14/2207 (0.6) | 212 (137–324) | 8 (57.1) | Candidiasis (9); aspergillosis (2); not specified (3) |
| Pazopanib | 3/525 (0.6) | 286 (185–303) | 1 (33.3) | Aspergillosis (1); candidiasis (1); not specified (1) |
| Regorafenib | 0/176 (0.0) | … | … | … |
| Ribociclib | 0/144 (0.0) | … | … | … |
| Ruxolitinib | 26/531 (4.9) | 191 (78–224) | 11 (42.3) | Candidiasis (6); aspergillosis (5); PCP (3); coccidioidomycosis (1); cryptococcosis (1); histoplasmosis (1); not specified (10) |
| Sorafenib | 9/252 (3.6) | 224 (146–328) | 2 (22.2) | Aspergillosis (4); candidiasis (1); not specified (4) |
| Sunitinib | 3/320 (0.9) | 263 (142–266) | 2 (66.7) | Candidiasis (2); PCP (1) |
| Tofacitinib | 24/5923 (0.4) | 193 (114–282) | 6 (25.0) | Candidiasis (15); PCP (3); coccidioidomycosis (1); not specified (5) |
| Trametinib | 3/255 (1.2) | 292 (249–294) | 2 (66.7) | PCP (1); aspergillosis (1); candidiasis (1) |
Abbreviations: IFI, invasive fungal infection; PCP, Pneumocystis pneumonia; SMKI, small molecule kinase inhibitor.
The analysis included SMKIs approved by the US Food and Drug Administration during 2001–2017, accessed at the official website (https://www.fda.gov/drugs/nda-and-bla-approvals/new-molecular-entity-nme-drug-and-new-biologic-approvals); the following SMKIs were excluded because <100 patients receiving the drug met study inclusion criteria: acalabrutinib, brigatinib, ceritinib, cobimetinib, gefitinib, ponatinib, temsirolimus, vandetanib, and vemurafenib.
Incidence was calculated as the number of patients in whom an IFI developed per person-year. Patients could receive >1 IFI diagnosis.