In a short Q&A, we caught up with Dr Neil Stone, who is bringing new trials of novel antifungal drugs to patients at UCLH, which has one of the largest cohorts in Europe for serious fungal infection, but until now, few current trials.
Dr Stone will deliver these trials thanks to funding from the UCLH Research Directorate awarded earlier this year aimed at achieving growth in clinical trials in under-researched areas.
Can you tell us about the trials you are planning to run which make use of antifungal drugs?
After decades of neglect finally there are several new antifungal drugs moving through the pipeline and into clinical trials. Planned trials include the use of a new, once weekly antifungal to prevent fungal disease in patients receiving stem cell transplants as well as treat patients with fungal complications of chronic respiratory conditions.
How could these trials benefit patients, now and in the future?
Participation in trials not only gives us information on how to treat serious fungal infection in general, it will give patients at UCLH the opportunity to receive the very latest treatments which include new orally available therapies or weekly injections (instead of having them daily).
Are there any challenges around running these trials which means that in the past it has been difficult to do this research?
Historically, fungal infections have been underfunded and under-researched, with a misconception that they are rare as compared to, for example, bacterial or viral infections. In fact, nearly 4 million people per year die of serious fungal infection – more than TB or malaria. This is now being recognised globally including by the WHO which has now identified fungal disease as a priority area for research into diagnosis and treatment of these diseases. Priority infections include aspergillosis and candidiasis, including the worrying and rapidly spreading fungal infection cause by the multi drug resistant yeast Candida auris.
UCLH has one of the largest cohorts in Europe for serious fungal infection. Why is this?
UCLH has a large cohort of patients with, and at risk of, fungal disease for several reasons. It commonly affects patients with weakened immune systems such as patients receiving treatments for cancers and in particular blood cancers such as leukaemia – UCLH is one of the biggest treatment centres in Europe for these conditions. Additionally fungal disease affects critically ill patients on intensive care and UCLH has a very large cohort of patients on critical care units around the trust. The Hospital for Tropical Diseases where I am based also sees a range of imported and travel related fungal disease in our unique cohort of returning travellers.
What is your research background to date, and how does this current work link in with your previous research?
My PhD was in cryptococcal meningitis, a serious fungal meningitis which is more common than bacterial meningitis in many parts of the world. I am lead for clinical mycology and work with the mycology (fungal disease laboratory) which serves UCLH. I have one of the only clinics for complex fungal infection in the UK. This, along with my clinical trials experience across a range of infectious diseases, puts me in an ideal position to lead on fungal disease clinical trials at UCLH.
About the funding from the UCLH Research Directorate
A funding call from the Research Directorate launched in 2024 is giving clinicians protected time to deliver research – both commercial and non-commercial – that they would otherwise not have capacity to do. Applications to the funding call were encouraged from clinicians working in clinical areas at UCLH that have significant opportunities for growth, where patients are currently under-served in research. The call was open to staff with prior research experience, but with fewer than 1 current PA (or 0.1 whole time equivalent) of time per week for research.
