MedPath

Acyclovir

Generic Name
Acyclovir
Brand Names
Sitavig, Xerese, Zovirax
Drug Type
Small Molecule
Chemical Formula
C8H11N5O3
CAS Number
59277-89-3
Unique Ingredient Identifier
X4HES1O11F
Background

Acyclovir is a nucleotide analog antiviral used to treat herpes simplex, Varicella zoster, herpes zoster, herpes labialis, and acute herpetic keratitis. Acyclovir is generally used first line in the treatment of these viruses and some products are indicated for patients as young as 6 years old.

Acyclovir was granted FDA approval on 29 March 1982.

Indication

An acyclovir topical cream is indicated to treat recurrent herpes labialis in immunocompetent patients 12 years and older. Acyclovir oral tablets, capsules, and suspensions are indicated to treat herpes zoster, genital herpes, and chickenpox. An acyclovir topical ointment is indicated to treat initial genital herpes and limited non-life-threatening mucocutaneous herpes simplex in immunocompromised patients. An acyclovir cream with hydrocortisone is indicated to treat recurrent herpes labialis, and shortening lesion healing time in patients 6 years and older. An acyclovir buccal tablet is indicated for the treatment of recurrent herpes labialis. An acyclovir ophthalmic ointment is indicated to treat acute herpetic keratitis.

Associated Conditions
Bell's Palsy, Chickenpox, Cytomegalovirus (CMV) Infections, Herpes Simplex Infections, Herpes Zoster, Herpes simplex encephalitis, Herpes simplex of the oral-labial, Herpes simplex type I reactivation, Recurrent Genital Herpes (RGH), Recurrent Herpes Labialis, VZV re-activation, Acute Genital herpes, Acute Herpes labialis, Acute Herpetic keratitis, Severe Genital herpes

Theralase's Light-Activated Ruvidar Shows Promising Results in BCG-Unresponsive Bladder Cancer Clinical Trial

• Theralase's Phase II clinical trial for BCG-Unresponsive Non-Muscle Invasive Bladder Cancer (NMIBC) shows 62.5% complete response rate with its light-activated small molecule Ruvidar. • The therapy demonstrates impressive durability with 45% of complete responders maintaining cancer-free status for at least 12 months, and some patients showing responses lasting over 7 years. • Theralase plans to complete trial enrollment by mid-2025, submit regulatory applications to Health Canada and FDA in late 2026, with potential market approval by early 2027.

Herpes Zoster Vaccine Shows Strong Protection for Stem Cell Transplant Recipients, Meta-Analysis Reveals

• A comprehensive meta-analysis of 3,048 hematopoietic stem cell transplant recipients demonstrates that herpes zoster vaccine reduces infection risk by 64%, with infection rates dropping from 18.3% to 6.4%. • The vaccine showed promising results in reducing post-herpetic neuralgia and other complications, while maintaining a favorable safety profile with no significant increase in adverse events. • Research primarily focused on autologous transplant recipients, highlighting the need for additional studies in allogeneic transplant populations to confirm vaccine efficacy and safety.

Theralase's Ruvidar® Shows Complete Healing of HSV-1 Lesions in Preclinical Study

• Theralase's topical Ruvidar® treatment demonstrated complete healing of HSV-1 cutaneous lesions in mice after four days of application, marking a significant breakthrough in herpes treatment. • The non-light activated therapy showed promising safety and efficacy in animal models, potentially offering new hope for billions affected by HSV infections worldwide. • Researchers plan to advance the development of both a therapeutic treatment and preventive vaccine for HSV, with clinical trials to follow these successful preclinical results.

Candel Therapeutics Highlights Pipeline Momentum with CAN-2409 and CAN-3110

• Candel Therapeutics is set to report updated overall survival data for CAN-2409 in pancreatic ductal adenocarcinoma and non-small cell lung cancer in Q1 2025. • The company is preparing for a Biologics License Application (BLA) submission for CAN-2409 in prostate cancer, expected in Q4 2026. • Phase 3 clinical trial data for CAN-2409 in prostate cancer will be presented at upcoming scientific conferences, marking a key milestone. • Overall survival data from the Phase 1b trial of CAN-3110 in recurrent high-grade glioma is anticipated in Q4 2025.

Real-World Data Reinforces Cilta-Cel Efficacy in Relapsed Multiple Myeloma, While Ide-Cel Shows Promise in CNS Involvement

• Real-world evidence confirms cilta-cel's effectiveness in relapsed/refractory multiple myeloma, mirroring clinical trial outcomes with high response rates and durable remission. • A significant portion of patients in the real-world study wouldn't have met clinical trial eligibility, highlighting cilta-cel's potential in a broader patient population. • Ide-cel demonstrates promising results in patients with CNS involvement of multiple myeloma, showing favorable responses and manageable safety profiles in a retrospective analysis. • Renal impairment does not significantly impact the efficacy of BCMA-targeting CAR T-cell therapies in relapsed/refractory multiple myeloma, though increased monitoring for ICANS and infections may be warranted.

Herpes Drug Resistance Linked to Viral Polymerase Conformation

• Researchers used cryo-EM to study herpes simplex virus (HSV) polymerase conformations in the presence of antiviral drugs, acyclovir and foscarnet, to understand resistance mechanisms. • Mutations in HSV polymerase affect the enzyme's finger movement, reducing antiviral drug binding strength and enabling the virus to overcome blocking effects. • The study suggests that drugs trapping HSV polymerase in a static conformation could help combat treatment resistance, offering insights for future drug development. • Scientists aim to develop algorithms predicting protein movement to forecast resistance in clinical settings, enhancing personalized treatment strategies for HSV infections.

Brivudine Shows Promise in Treating Herpes Zoster, Meta-Analysis Suggests

• A recent meta-analysis indicates that brivudine is more effective than acyclovir and valaciclovir in treating herpes zoster (HZ), commonly known as shingles. • The study suggests brivudine reduces recovery time and the occurrence of postherpetic neuralgia (PHN) compared to other antiviral treatments. • Safety analysis showed no significant differences in adverse reactions among brivudine, acyclovir, and valaciclovir treatments for herpes zoster. • Researchers call for larger studies to further validate brivudine's safety and efficacy in treating shingles, despite promising initial results.

Obe-cel Approved for Relapsed/Refractory B-Cell ALL: A New CAR T-Cell Therapy Option

• Obecabtagene autoleucel (obe-cel) received FDA approval in November 2024 for adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). • The approval was based on the FELIX trial, which demonstrated high overall remission rates and a manageable safety profile with split dosing. • Obe-cel's unique fast-off target binding and 4-1BB construct may lead to decreased T-cell exhaustion and reduced cytokine release syndrome (CRS) and neurotoxicity. • Analysis of the FELIX trial data suggests that patients with low-risk scores may experience better outcomes with obe-cel treatment.

Datopotamab Deruxtecan Shows Promise in Advanced Non-Small Cell Lung Cancer

• Datopotamab deruxtecan shows a clinically meaningful trend in improving overall survival for advanced nonsquamous non-small cell lung cancer patients who have received prior therapy. • In nonsquamous NSCLC patients, datopotamab deruxtecan improved overall survival by 2.3 months compared to docetaxel, regardless of actionable genomic alterations. • NeoCOAST-2 trial results show datopotamab deruxtecan plus IMFINZI and chemotherapy demonstrating promising response rates in early-stage resectable NSCLC patients. • AstraZeneca and Roche Tissue Diagnostics are collaborating to co-develop a TROP2-QCS biomarker companion diagnostic to identify patients most likely to benefit from datopotamab deruxtecan.

Mycophenolate Mofetil Shows Promise in Phase II Osteosarcoma Trial

• A Phase II clinical trial is evaluating mycophenolate mofetil's efficacy and safety in patients with high-grade locally advanced or metastatic osteosarcoma. • The trial aims to determine progression-free survival at 16 weeks as the primary endpoint, with secondary endpoints including overall survival and safety parameters. • Mycophenolate mofetil, an immunosuppressant, has shown anticancer activity against osteosarcoma in preclinical studies, warranting further investigation in humans. • The study involves multiple centers in Thailand and includes adolescent and adult patients who have progressed after standard chemotherapy or are not candidates for it.
© Copyright 2025. All Rights Reserved by MedPath