Objective:

To evaluate the real-world usage and pharmacokinetics of isavuconazole in pediatric patients with cancer, and to analyze busulfan pharmacokinetics in adults, focusing on treatment outcomes.

Key Findings:

• Isavuconazole was administered to 55 pediatric patients, primarily for therapy (69.7%) and secondary prophylaxis (40.9%).
• The median Ctrough for isavuconazole was 3.3 mg/L, with significant variability in drug concentration, indicating the need for careful monitoring.
• Isavuconazole was well tolerated, with only 3.0% experiencing grade 3 or 4 toxicity, suggesting a favorable safety profile.
• Busulfan TDM was analyzed in 287 adult patients, focusing on the impact of overweight/obesity and comedication on pharmacokinetics.

Interpretation:

Isavuconazole is a viable antifungal option for pediatric patients with cancer, necessitating dose adjustments based on drug concentrations to optimize efficacy. Busulfan pharmacokinetics underscore the importance of TDM for enhancing treatment outcomes.

Limitations:

• The retrospective design may introduce bias, limiting the reliability of the findings.
• Generalizability is restricted due to the single-center nature of the studies, which may not reflect broader patient populations.

Conclusion:

Isavuconazole shows promise in pediatric antifungal therapy, while busulfan TDM is essential for optimizing treatment in adults, highlighting the need for individualized patient care.