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• Posted December 24, 2024

Last Year's Platinum-Based Drugs Shortage Didn't Raise Cancer Deaths, Study Found

When supplies of certain generic, platinum-based cancer chemotherapies dwindled in 2023, oncologists feared it might lead to under-treatment and many more cancer deaths.

Fortunately, that did not turn out to be the case, a new study published recently in the Journal of the National Cancer Institute shows.

“When we looked at the data on prescribing practices over the shortage period, compared to the previous year, we found that although reporting of the shortages was widespread, it didn't affect as many patients as we had feared," said lead study author Dr. Jacob Reibel. He's a third-year fellow in hematology-oncology at Penn Medicine’s Abramson Cancer Center in Philadelphia.

As the research team explained, in the late winter and spring of 2023 the U.S. Food and Drug Administration first warned of shortages of two platinum-bearing chemotherapy drugs, cisplatin and carboplatin.

Both have been around for decades and are widely used to treat cancers of the lung, head and neck, breast, bladder, ovaries, uterus and testicles. 

“At the time, national surveys showed that most cancer centers in the U.S. were reporting shortages of these platinum chemotherapies, but it wasn’t clear how the shortages were actually affecting patients,” Reibel said in a Penn news release.

The shortages peaked in June of 2023 and slowly eased thereafter.

How badly did these temporary shortages affect cancer patients?

To find out, Reibel's team tracked data on nearly 12,000 cancer patients treated in 2023 at centers across the United States. All had advanced, solid-tissue cancers for which platinum-based chemotherapies are often recommended.

The study found that the shortages led to only a 2.7% dip in use of the two drugs between February 2023 and January 2024.

That means that about 137 fewer patients in the study group got platinum chemotherapy than would have been expected had no shortage happened, Reibel and team estimated.

Extrapolated to the nationwide population, they calculated that about 1,000 patients with advanced solid tumors were probably affected overall.

At the peak of the shortage, about 15% of patients probably had trouble accessing a platinum chemotherapy drug, the study found.

But there was good news, too: Despite the shortages, the study team could find no difference in death rates for patients with solid tumor cancers in 2023 versus the year before.

Why might that be so? Probably because oncologists now have more drug treatment options; medications such as immune checkpoint inhibitors, targeted therapies or other forms of chemotherapy, the researchers said.

Of course, these newer drugs can be much more expensive that generic cisplatin and carboplatin.

“We always want to prioritize the best treatments that we have for patients, and platinum chemotherapies just happen to also be very cost-effective because they’re generic and have been around for decades,” senior study author Dr. Ronac Mamtani noted.

Cost can be a factor in prescribing any medication, of course.

“While the alternative options may be effective, we want to be able to provide the ‘standard-of-care’ medications to any patient in need," said Mamtani, who is chief of genitourinary cancers at the cancer center. "Even one hundred patients who can’t get the preferred chemotherapy for their cancer type due to supply chain issues is far too many.” 

The researchers noted that shortages for cisplatin were over by June of 2024, although a shortage of carboplatin remains. However, prescribing levels for both drugs have by now returned to normal.

More information

Find out more about cisplatin at the U.S. National Cancer Institute.

SOURCE: University of Pennsylvania, news release, Dec. 13, 2024