Expert Describes Impact of Chemotherapy Shortage on Gynecologic Cancers

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Brian Slomovitz, MD, MS, FACOG, notes that sometimes there is a need to substitute cisplatin for carboplatin, and vice versa, to best manage gynecologic cancers during the chemotherapy shortage.

Treating those with gynecologic cancers amid the ongoing chemotherapy shortage has been a struggle, albeit one that gynecologic oncologists are able to handle, according to Brian Slomovitz, MD, MS, FACOG in an interview with CancerNetwork®. Although the situation is critical for certain institutions that are lacking in these agents, he also stated a feeling of optimism that the end of the shortage should be in sight.

Slomovitz, a gynecologic oncologist, director of Gynecologic Oncology, and co-chair of the Cancer Research Committee at Mount Sinai Medical Center in Miami Beach, Florida and a professor of Obstetrics and Gynecology at Florida International University, detailed how shortages of carboplatin and cisplatin in the United States have impacted the way he manages gynecologic cancers, such as occasionally needing to switch out one platinum-based agent for another.

However, he noted that his institution hasn’t been impacted as heavily as others, indicating that patients who are already enrolled on clinical trials and those who can receive the agents with treatment intent are still able to undergo treatment with cisplatin and carboplatin. On a national scale, he discussed how some institutions are unable to treat their patients with platinum-based chemotherapy altogether or enroll patients on new trials due to lacking these agents.

Transcript:

We're making such great strides in medical advances using molecular classifications, artificial intelligence, the latest and greatest molecular treatments, and immunotherapies, [but] we ran out of platinum drugs?Number one, we need to look at our processes. We need to look at not just what's the most profitable, but what's really the most necessary. It's very upsetting to me as a practicing oncologist when I think about treating women who could live longer, treating women who could survive with these drugs, and how we got into this [shortage]. That's one thing we need to look at.

As far as how we're handling it day to day, I would say 2 things: It has been a struggle, but it has been a struggle that we've been able to handle for the most part. Patients of mine who can get platinum for treatment intent are still able to get it. My patients who are on clinical trials are still able to get it. Sometimes, I've had to change one or the other—for patients I normally give cisplatin to, I have given carboplatin, and for patients who normally get carboplatin, I've given cisplatin.

But I do know that it's not just about what I have, but it's what's going on nationally. I know there are institutions that don't have it. There are institutions that aren't able to give their patients the best standard-of-care therapy and aren't able to enroll patients in trials because of lack of therapy. Hopefully, an end's in sight. I do see the light at the end of the tunnel, and we'll get there. But it has been a problem. This is a problem that we can prevent from happening in the future. We just need to do it.

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