Doctors who specialize in pediatric cancer are raising awareness about the growing lack of pediatric chemotherapy medications.
The current cancer medicine supply issue, which has caused doctors to scramble and patients to face challenging treatment decisions since early February, is now compounded by the diminishing supplies.
In certain situations, the measures made by the Biden administration to resolve the crisis have been successful: According to physicians, the shortages of the cancer medications carboplatin and cisplatin have greatly subsided in recent weeks.
Vinblastine and dacarbazine are two other chemotherapy medications that are frequently used to treat pediatric tumors, however reports from children’s hospitals around the US indicate that there may be supply issues with these medications. Methotrexate, another chemotherapy medication frequently used in children, has been in short supply since March and is still difficult to find.
All three medications are used to treat a variety of malignancies, however vinblastine and dacarbazine are most frequently used for Hodgkin lymphoma in young patients. The preferred treatment for acute lymphoblastic leukemia, the most prevalent malignancy in children, is methotrexate.
Due to shortages, physicians are forced to use less potent substitutes or postpone therapy until the pharmaceuticals are once again available.
Dr. Doug Hawkins, chair of the Children’s Oncology Group, a national research group, described it as “devastating.” Can you picture receiving the news that your child has cancer and that there is a 70%, 80%, or 90% probability that standard treatment can cure them? Oh, and by the way, we aren’t able to get any of those standard treatments?
Not resolving the issue at scale
Although carboplatin and cisplatin are still two of the 15 medications that the White House lists as being in limited supply, the Biden administration announced this month that supplies are practically where they were prior to the crisis. .
Breast and gynecologic medical oncologist Dr. Eleonora Teplinsky stated that the carboplatin and cisplatin supplies are “significantly better,” if not totally addressed, at her facility in Ridgewood, New Jersey.
Her colleagues, who treat blood malignancies, have recently expressed grave worries about the supply of vinblastine. Cancers of the blood include lymphoma and leukemia.
Vinblastine and dacarbazine supply problems were first noted this month, according to the American Society of Health-System Pharmacists, a body that monitors medicine shortages.
“What we’ve seen is that they’ve been able to fix individual shortages, but we’re still not fixing the problem at large,” Teplinsky, who oversees the breast medical oncology team at Valley Health System, said of the federal government’s response to the medicine shortages.
She noted that in some situations, doctors may substitute vincristine for vinblastine, but this medication has a different set of adverse effects and can be less effective.
Other times, however, there are no other options. For older kids with Hodgkin lymphoma, a four-drug combination therapy with vinblastine and dacarbazine is employed. Doctors have no other options, according to Hawkins, without those medications.
To address the methotrexate shortage that has existed since March, the Biden administration is also seeking to increase the drug’s availability.
After a brief improvement in the availability of methotrexate, according to Dr. Tara Henderson, chief of pediatric hematology and oncology at UChicago Medicine, the issue is resurfacing.
When conventional treatments are available, methotrexate is a “backbone drug” for leukemia with a cure rate of more than 90%, according to the expert.
We may not have the resources to cure the children who have cancer and other treatable ailments, according to Henderson.
It seems like it ought to be a top priority for the country, she remarked. “I believe that we need to work together to solve these problems.”
The supply chain is dysfunctional.
The Leukemia & Lymphoma Society’s president and CEO, Dr. Anders Kolb, said the shortages have compelled hospitals to change how they stock their pharmacies, including ordering in bulk and making sure they have alternate treatment options on hand.
He said, “They’re trying to stay three steps ahead.” “It’s not like you just plug it into Amazon if you run out of something and it shows up the next day,”
The American Society of Clinical Oncology’s chief medical officer and executive vice president, Dr. Julie Gralow, declared that “the supply chain is broken.”
The group has been pressing various government agencies, including the Food and medicine Administration and the White House, to put in place an early warning system for medicine shortages. This method would also provide light on the causes of the current medicine shortages.
We don’t currently have a solid grasp of their history and what puts them in danger, according to Gralow.
Drug supply issues are nothing new. This has been going on for years, according to Hawkins. “They’re just becoming more prevalent, common, and lasting longer.”
He claimed that in addition to making doctors feel powerless, the shortages also make families and children feel even more hopeless.
It won’t boost survival, but we hope it won’t have a significant impact either, according to Hawkins. And so, in my opinion, that’s simply horrible from the perspective of the families.