Dr Fonkoua on Alternatives to Platinum Chemotherapy in Cancer Care

Lionel A. Kankeu Fonkoua, MD, medical oncologist, Department of Medical Oncology, Mayo Clinic, discusses challenges arising from the ongoing shortage of platinum chemotherapy in the United States and suggests potential alternatives to cisplatin that may benefit patients with cancer during this shortage.

In June 2023, the National Comprehensive Cancer Center (NCCN) released results from the NCCN Best Practices Committee Carboplatin & Cisplatin Shortage Survey, which was conducted between May 23 and May 31, 2023, and included answers from 27 NCCN member institutions. This survey found that 93% and 70% of participating institutions reported shortages of carboplatin and cisplatin, respectively. Although all the surveyed centers noted that they could still treat patients in need of cisplatin with no delays or claim denials, only 64% were able to continue administering carboplatin to all patients currently receiving that drug. Additionally, 16% of the surveyed centers faced treatment delays from the need to re-obtain prior authorization for treatment plan modifications in response to these shortages. 

Throughout the ongoing platinum chemotherapy shortage, which affects patients with several different cancer types for which platinum-based regimens are standard treatments, centers across the United States have been attempting creative solutions using different platinum agents, Fonkoua says. For instance, many cancer centers experiencing a lack of cisplatin have considered using other platinum agents in greater supply, such as oxaliplatin and carboplatin, Fonkoua explains. Although the efficacy of carboplatin and oxaliplatin has not been tested across tumor types, they may be feasible alternatives to cisplatin for certain patients, Fonkoua emphasizes. 

Although several institutions still have access to oxaliplatin and cisplatin, the national supply of these agents may decrease, following the pattern of cisplatin availability, Fonkoua notes. If the supply of these agents does not increase, cancer centers may completely run out of these therapies and have limited treatment alternatives for patients who rely on platinum-based regimens, Fonkoua concludes.