{"title":"Motor fluctuations in Parkinson disease - a mini-review of emerging drugs.","authors":"Priti Gros, Laura Armengou Garcia, Susan H Fox","doi":"10.1080/14728214.2025.2517582","DOIUrl":"10.1080/14728214.2025.2517582","url":null,"abstract":"<p><strong>Introduction: </strong>The symptomatic treatment of Parkinson Disease (PD) relies on levodopa. With disease progression, the response to levodopa becomes variable, leading to fluctuations in benefit on PD symptoms. These motor fluctuations are challenging to manage and negatively impact quality of life in PD.</p><p><strong>Areas covered: </strong>We provide a review of experimental, non-approved pharmacological therapies in phase II and III clinical trials from 2018 to 2024 for PD motor fluctuations.</p><p><strong>Expert opinion: </strong>New formulations of levodopa to improve bioavailability are in development. These include another subcutaneous infusion with efficacy in reducing motor fluctuations and an intranasal delivery with tolerability reported. An oromucosal formulation of apomorphine was safe, further studies are needed. Preliminary results of a phase III study of dopamine D1/D5 agonist tavapadon and phase II of CVN424, a GRP6 inverse agonist suggest improved ON time. Negative studies were reported with foliglurax (MGluR4 inverse agonist) and the repurposed drugs naftazone and bumetanide. Several novel targets are in early-stage development with results awaited. Overall, it is unclear whether the field is significantly further ahead, as the benefit of these emerging drugs in comparison with currently available agents for motor fluctuations needs to be clarified.</p>","PeriodicalId":12292,"journal":{"name":"Expert Opinion on Emerging Drugs","volume":" ","pages":"179-190"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mario Ascione, Giuseppe D'Angelo, Mario Palumbo, Pierluigi Giampaolino, Giuseppe Bifulco, Luigi Della Corte
{"title":"Advancements and challenges: shaping the future of vulvar cancer care.","authors":"Mario Ascione, Giuseppe D'Angelo, Mario Palumbo, Pierluigi Giampaolino, Giuseppe Bifulco, Luigi Della Corte","doi":"10.1080/14728214.2025.2575571","DOIUrl":"10.1080/14728214.2025.2575571","url":null,"abstract":"","PeriodicalId":12292,"journal":{"name":"Expert Opinion on Emerging Drugs","volume":" ","pages":"163-167"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clifton C Mo, Yuxin Liu, Omar Nadeem, Shonali Midha, Jacob P Laubach, Taya Jamal Salman, Taylor Nicholson, Kaleigh Donnelly, Giada Bianchi, Adam S Sperling, Monique A Hartley-Brown, Paul G Richardson
{"title":"Mezigdomide for multiple myeloma: a focus on phase 2 trial data.","authors":"Clifton C Mo, Yuxin Liu, Omar Nadeem, Shonali Midha, Jacob P Laubach, Taya Jamal Salman, Taylor Nicholson, Kaleigh Donnelly, Giada Bianchi, Adam S Sperling, Monique A Hartley-Brown, Paul G Richardson","doi":"10.1080/14728214.2025.2575570","DOIUrl":"10.1080/14728214.2025.2575570","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment armamentarium for multiple myeloma (MM) has evolved substantially over the past 20 years. Standard-of-care regimens for newly diagnosed MM and early relapsed/refractory disease (RRMM) include quadruplets and triplets comprising CD38 monoclonal antibodies, proteasome inhibitors, and/or immunomodulatory drugs, plus dexamethasone. Targeted agents and immune-based therapies are being used increasingly early in the treatment algorithm. There is an ongoing need for novel treatment options to improve outcomes with existing therapies and in subsequent lines of treatment.</p><p><strong>Areas covered: </strong>We review preclinical/clinical data on the cereblon E3 ligase modulator mezigdomide, which is in phase 3 investigation in RRMM. We searched the published literature using PubMed, plus congress abstracts from the past 5 years and current records on ClinicalTrials.gov, using the terms 'mezigdomide' or 'CC-92480' and 'myeloma.'</p><p><strong>Expert opinion: </strong>Mezigdomide, which is not currently approved for the treatment of MM, has higher cereblon binding affinity and greater potency for substrate protein degradation than the immunomodulatory drugs, and this is translating into notable clinical efficacy in early-phase trials, including in poor-prognosis settings such as triple-class-refractory disease. It has shown synergistic effects in preclinical studies with standard-of-care therapies and is being evaluated clinically in various combinations, including with/following T-cell engaging therapies for RRMM.</p>","PeriodicalId":12292,"journal":{"name":"Expert Opinion on Emerging Drugs","volume":" ","pages":"209-219"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145400297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Emerging drugs for the treatment of bullous pemphigoid: what's new on the horizon?","authors":"Henning Olbrich, Christian D Sadik","doi":"10.1080/14728214.2025.2555080","DOIUrl":"10.1080/14728214.2025.2555080","url":null,"abstract":"<p><strong>Introduction: </strong>Bullous pemphigoid (BP) is the most prevalent autoimmune blistering disorder. It is associated with high mortality partially due to side-effects of immunosuppressive drugs. Development of new therapeutics for BP has turned out to be exceedingly challenging, among others, due to frailty of the patients and heterogeneity of the disease.</p><p><strong>Areas covered: </strong>This review summarizes current clinical trials examining new potential drugs for BP. Strategies targeting the activity of eosinophils, complement activation, leukotriene B<sub>4</sub>, the neonatal Fc receptor, and T<sub>H</sub>2 cell cytokines are discussed.</p><p><strong>Expert opinion: </strong>Strategies recently under investigation for BP have largely failed. Only the inhibition of IL-4/IL-13 signaling by dupilumab met its primary endpoint. However, its effects were rather modest, and limited to a patient subgroup. All strategies directly or indirectly targeting eosinophils, including the depletion of eosinophils by benralizumab, failed. The reason might be a more significant or redundant role of neutrophils in BP. Strategies targeting neutrophils, e.g. by inhibition of LTB<sub>4</sub> should, therefore, be further pursued. Additionally, new kinase inhibitors, such as inhibitors of JAK, Syk, Src kinases, and BTK, should be tested because they would presumably inhibit multiple immune cell populations, including neutrophils, which is possibly required to achieve pronounced therapeutic effects in BP.</p>","PeriodicalId":12292,"journal":{"name":"Expert Opinion on Emerging Drugs","volume":" ","pages":"169-178"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144948288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniela Pastore, Chiara Lupia, Maria D'Amato, Andrea Bruni, Eugenio Garofalo, Federico Longhini, Luca Gallelli, Alessandro Vatrella, Girolamo Pelaia, Corrado Pelaia
{"title":"Emerging biological treatments for asthma.","authors":"Daniela Pastore, Chiara Lupia, Maria D'Amato, Andrea Bruni, Eugenio Garofalo, Federico Longhini, Luca Gallelli, Alessandro Vatrella, Girolamo Pelaia, Corrado Pelaia","doi":"10.1080/14728214.2025.2460529","DOIUrl":"10.1080/14728214.2025.2460529","url":null,"abstract":"<p><strong>Introduction: </strong>Severe asthma is a chronic airway disease characterized by many pathomechanisms known as endotypes. Biological therapies targeting severe asthma endotypes have significantly improved the treatment of this disease, thus remarkably bettering patient quality of life.</p><p><strong>Areas covered: </strong>This review aims to describe current biological therapies for severe asthma, highlighting emerging ones. Several studies have confirmed the beneficial effects of currently available monoclonal antibodies targeting immunoglobulin E (IgE), interleukin-5 (IL-5) or its receptor, and interleukin-4 (IL-4)/interleukin-13 (IL-13) receptors (IL-4R/IL-13R). However, patients with T2-low asthma are not eligible for the above biological therapies.</p><p><strong>Expert opinion: </strong>New treatments are now moving toward targeting the upstream pathways of asthma pathogenesis, coordinated by innate cytokines such as alarmins. These key proinflammatory mediators orchestrate the activation of complex cellular networks including both innate and adaptive immune responses. Alarmins include thymic stromal lymphopoietin (TSLP), interleukin-25 (IL-25), and interleukin-33 (IL-33), which are released from injured airway epithelial cells. TSLP and the other alarmins are suitable targets of biological therapies which are effective for add-on treatment of type 2 asthma. Moreover, anti-alarmin monoclonal antibodies can be also beneficial for patients with T2-low, poorly controlled severe asthma.</p>","PeriodicalId":12292,"journal":{"name":"Expert Opinion on Emerging Drugs","volume":" ","pages":"87-97"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Newly emerging tyrosine kinase inhibitors for the treatment of neuroendocrine neoplasms.","authors":"Nicola Fazio, Anna La Salvia","doi":"10.1080/14728214.2025.2508994","DOIUrl":"10.1080/14728214.2025.2508994","url":null,"abstract":"<p><strong>Introduction: </strong>In the era of precision medicine, a molecularly targeted therapeutical approach is still missing in the field of neuroendocrine neoplasms (NENs) other than for radioligand therapy (RLT). So far sunitinib is the only tyrosine kinase inhibitor (TKI) available in clinical practice for NENs in Western countries, limited to advanced, progressing pancreatic neuroendocrine tumors (NETs). A few TKIs worldwide reached an advanced stage of clinical investigation with promising results.</p><p><strong>Areas covered: </strong>This narrative review is an updated analysis about the status of TKIs in the most advanced stage of clinical investigation in NENs. Our work is focused specifically on a critical analysis of TKIs investigated in phase III clinical trials, such as Axitinib, Surufatinib, and Cabozantinib.</p><p><strong>Expert opinion: </strong>The Expert Opinion section of our manuscript is a critical overview of the results coming from phase II and III clinical trials with Axitinib, Surufatinib, and Cabozantinib, and, it is mainly centered on strategies of investigation of these TKIs, including geographical areas and indirect comparison about study design.</p>","PeriodicalId":12292,"journal":{"name":"Expert Opinion on Emerging Drugs","volume":" ","pages":"149-157"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria-Alejandra Umbacia, Marta Ximena Leon, Jose-Manuel Quintero, Lina-Maria Castro, Veronica Paez, Seetal Dodd, Rosa-Helena Bustos
{"title":"Exploring psilocybin's role in mental health and palliative medicine: a path to improved well-being.","authors":"Maria-Alejandra Umbacia, Marta Ximena Leon, Jose-Manuel Quintero, Lina-Maria Castro, Veronica Paez, Seetal Dodd, Rosa-Helena Bustos","doi":"10.1080/14728214.2025.2488786","DOIUrl":"10.1080/14728214.2025.2488786","url":null,"abstract":"<p><strong>Introduction: </strong>Although long known for their psychoactive effects, psychedelic drugs have only recently been investigated for medicinal use. Psilocybin has attracted the greatest interest with studies suggesting that it may be a useful agent in psychiatry and in palliative care.</p><p><strong>Areas covered: </strong>Clinical trials that included psilocybin were searched in PubMed, Embase, and ClinicalTrials.gov, demonstrating that adult psychiatry and palliative care are the medical fields that show the greatest interest in psilocybin treatment.</p><p><strong>Expert opinion: </strong>Psilocybin is a powerful drug that needs to be used with caution but may benefit some patients, including when other options have failed. It is best evidenced in treatment resistant depression and in palliative care, where patients are usually treated in specialist care centers. It has a novel mechanism of action, targeting the 5HT2A receptor, and can show rapid onset of action. There are many questions regarding its use that remain to be clarified, including its efficacy for other indications and its role as adjunctive treatment in psychotherapy. The psychoactive, or psychedelic effects are well documented, but their clinical importance is disputed.</p>","PeriodicalId":12292,"journal":{"name":"Expert Opinion on Emerging Drugs","volume":" ","pages":"99-108"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Emerging therapeutics targeting tumor-associated macrophages for the treatment of solid organ cancers.","authors":"Dandan Li, Udo Rudloff","doi":"10.1080/14728214.2025.2504376","DOIUrl":"10.1080/14728214.2025.2504376","url":null,"abstract":"<p><strong>Introduction: </strong>Over the last decade, immune checkpoint inhibitors (ICIs) like PD-1/PD-L1 or CTLA-4, which reinvigorate T cells for tumor control have become standard-of-care treatment options. In response to the increasingly recognized mechanisms of resistance to T cell activation in immunologically cold tumors, immuno-oncology drug development has started to shift beyond T cell approaches. These include tumor-associated macrophages (TAMs), a major pro-tumor immune cell population in the tumor microenvironment known to silence immune responses.</p><p><strong>Areas covered: </strong>Here we outline anti-TAM therapies in current development, either as monotherapy or in combination with other treatment modalities. We describe emerging drugs targeting TAMs under investigation in phase II and III testing with a focus on their distinguishing mechanism of action which include (1) reprogramming of TAMs toward anti-tumor function and immune surveillance, (2) blockade of recruitment, and (3) reduction and ablation of TAMs.</p><p><strong>Expert opinion: </strong>Several new immuno-oncology agents are under investigation to harness anti-tumor functions of TAMs. While robust anti-tumor efficacy of anti-TAM therapies across advanced solid organ cancers remains elusive to-date, TAM reprogramming therapies have yielded benefits in select cancers. The inherent heterogeneity of the diverse TAM population will require enhanced investments into biomarker-driven approaches to fully leverage its therapeutic potential.</p>","PeriodicalId":12292,"journal":{"name":"Expert Opinion on Emerging Drugs","volume":" ","pages":"109-147"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}