[Joan M]

Rich,

Yes, I did. When I had the fungal ball, or mycetoma, in my lung, I took voriconazole, which is an advanced form of itraconazozle. I then came across an article last spring about itraconazole's potential use in blocking the Hedgehog pathway in cancer. I sent an e-mail to the scientist doing the research, asking whether voriconazole would have the same effect. Here's his answer (which I really appreciated, as he took the time to explain it):

Please be aware that I am not clinically trained and cannot advise you on your medical condition.

In response to your question, our article described an effect of itraconazole on the Hedgehog signaling pathway, which plays an important role in organizing the normal pattern of embryonic growth and development, and also can play a role in the abnormal growth of certain tumors.

The effect of itraconazole on Hedgehog signaling is by a mechanism distinct from its effect on fungal growth. Other antifungal drugs, including voraconazole (Vfend) act on fungal growth by a mechanism similar to that of itraconazole but, unlike itraconazole, do not efficiently inhibit the Hh pathway. We specifically tested several other azole antifungals (the class of drug that includes itraconazole and voraconazole) and saw little effect if any on Hedgehog signaling (voraconazole was completely inactive in affecting the Hedgehog pathway).

To help you think about this, imagine two keys that have similar shafts and can both open the same lock, but have very different bows (the part you hold when you are turning the key). In this analogy, the effect of itraconazole on the Hh pathway is due to the structure of the bow. Voraconazole is also able to inhibit fungal growth because it has a similar shaft, but not the Hedgehog pathway because the bow is very different.

I would therefore not expect your treatment with Vfend to have had much or any effect on the Hedgehog pathway. A separate question is what role the Hedgehog signaling pathway may have in breast cancer. I cannot answer that question, although we are interested and have attempted to obtain funding to study it (with no success thus far).

I hope this helps. I wish you all the best.

*****
I was hoping to get a lucky break since I took Vfend for four months. Genetech is also studying the Hedgehog pathway in breast cancer.

Joan