During a shortage of the generic platinum chemotherapy drugs cisplatin and carboplatin that began in early 2023, there was no difference in mortality rates among patients with advanced cancer compared to the previous year, and prescription rates for the two drugs fell less than 3% overall—and 15.1% at the peak—according to an analysis published in the Journal of the National Cancer Institute by researchers from the Perelman School of Medicine and Penn Medicine’s Abramson Cancer Center.
Cisplatin and carboplatin—which have been approved for more than 30 years—are widely used to treat a variety of cancers, including lung, head and neck, breast, bladder, ovarian, uterine, and testicular cancers. When the FDA announced a shortage of cisplatin in February 2023, followed by a shortage of carboplatin in April 2023, it drew attention to the ongoing challenge of generic drug shortages, and prompted major national oncology societies to recommend best practices for priority use and alternative medicines.
“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,” says lead author Jacob B. Reibel, a third-year fellow in Hematology-Oncology. “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.”
The researchers hypothesized that the limited impact on mortality was likely due to the use of effective alternative medications recommended by medical societies, such as immune checkpoint inhibitors, targeted therapy or other forms of chemotherapy. The study did not assess the potential drawbacks of alternative medications, including the financial burden of more expensive non-generic alternatives and side effects of different drugs.
“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,” says senior author Ronac Mamtani, section chief of genitourinary cancers. “While the alternative options may be effective, we want to be able to provide the ‘standard-of-care’ medications to any patient in need. Even 100 patients who can’t get the preferred chemotherapy for their cancer type due to supply chain issues is far too many.”
Read more at Penn Medicine News.
