Given the presence of distant metastases, the patient was commenced on neoadjuvant chemotherapy and mitotane. Genetic testing for TP53 to evaluate Li-Fraumeni syndrome was declined. Despite initial response to the treatment, the disease remained refractory, and the patient succumbed after seven months of therapy.

P1, N=10, Active, not recruiting, University of Kansas Medical Center | Trial completion date: Jun 2026 --> Dec 2026

P1, N=36, Not yet recruiting, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

P1, N=14, Active, not recruiting, Pfizer | Not yet recruiting --> Active, not recruiting

Taken together, these findings support itraconazole as a promising candidate for further in vivo and clinical investigation in selected oral cancers, including HNSCC and OSCC. Nevertheless, the definition of clinical treatment schedules will require additional comprehensive pharmacokinetic, toxicological, and clinical studies.

The topoisomerase I inhibitor payload (DXd) released from the human epidermal growth factor receptor 2-targeted antibody-drug conjugate (ADC) trastuzumab deruxtecan (T-DXd) is eliminated by hepatic uptake via OATP1B1/3, metabolism by CYP3A, biliary excretion via P-glycoprotein and breast cancer resistance protein, and urinary excretion. DDIs with ritonavir and itraconazole simulated by the PBPK model reproduced the clinical DDI study results, indicating that the impact of concomitant medications was not clinically meaningful. These findings suggest that this model may potentially be used for DDI evaluation of future DXd-containing ADCs, aiding in the prediction of DDIs under different scenarios and in specific populations.

Voriconazole and itraconazole are commonly used for maintenance therapy. Treatment and long-time management remain a challenge. Besides, long lasting anti-fungal and immune boosting therapy may be necessary, while HSCT intervention could provide potential benefits.

P=N/A, N=114, Recruiting, Guy's and St Thomas' NHS Foundation Trust | Not yet recruiting --> Recruiting

P4, N=30, Recruiting, Mayo Clinic | Initiation date: Mar 2026 --> Jun 2026

Treatment consisted of oral ketoconazole 400 mg daily for six months, resulting in complete clinical recovery with radiographic evidence of bone healing at one‑year follow-up. In conclusion, this case underscores the critical need to consider fungal etiologies in the differential diagnosis of subacute osteomyelitis, even in young patients without traditional risk factors. A high index of suspicion, combined with early surgical intervention and targeted antifungal therapy, is paramount for achieving a favorable clinical outcome and preventing long‑term morbidity.

Ectopic adrenocorticotropic hormone syndrome was confirmed via dexamethasone suppression testing and somatostatin receptor-targeted positron emission tomography-computed tomography, which localized an ectopic adrenocorticotropic hormone-secreting right pulmonary carcinoid tumor (a neuroendocrine tumor). During hospitalization, the patient was diagnosed with concurrent Pneumocystis jirovecii pneumonia and pulmonary cryptococcosis, and he responded favorably to trimethoprim-sulfamethoxazole and fluconazole. This case, supported by a review of the relevant literature, highlights the importance of early infection diagnosis, prompt management, and appropriate prophylaxis in patients with ectopic adrenocorticotropic hormone syndrome to improve prognosis.

Treatment was individualized: severe cases received extended amphotericin B lipid complex (ABLC) (cumulative dose up to 31.8g in case1) induction followed by azole maintenance; milder cases received oral itraconazole alone...NGS was essential for early detection. Individualized antifungal therapy-tailored to immune status and disease severity achieved favorable outcomes, underscoring the importance of personalized treatment strategies.