Dr Massarelli on Effectively Treating Patients During the United States Chemotherapy Shortage

Erminia Massarelli, MD, PhD, MS, co-director, Lung Cancer and Thoracic Oncology Program, section chief, Thoracic Oncology, associate professor, Department of Medical Oncology & Therapeutics Research, City of Hope, discusses strategies created by City of Hope to effectively navigate the treatment of patients with lung cancer during the platinum chemotherapy shortage in the United States.

Of the 27 institutions in the United States polled by the National Comprehensive Cancer Network (NCCN) Best Practices Committee between May 23 and 31, 2023, 93% are experiencing a shortage of carboplatin, and 70% currently have a shortage of cisplatin. As a result, many institutions have enacted strategies to reduce the burden of this shortage and ensure patients are still able to receive adequate, necessary treatment.

Leaders at City of Hope aimed to prioritize the administration of their current platinum-based chemotherapy supply for patients in the curative setting, as well as those who did not have treatment alternatives, Massarelli states. This includes the majority of patients within the lung cancer space, specifically patients in the first line, Massarelli notes.

For the remaining patients, the institution was tasked with identifying effective and appropriate alternative regimens for treating their patients with cancer in the interim. One approach considered for patients with advanced lung cancer in the first line was the phase 3 CheckMate 9LA [NCT03215706] regimen of nivolumab (Opdivo) plus ipilimumab (Yervoy) combined with 2 cycles of platinum chemotherapy, Massarelli says. As this regimen includes less chemotherapy, it was an ideal approach to help conserve the current supply of platinum agents, while still remaining efficacious, Massarelli explains.

Ultimately, the majority of patients at City of Hope were able to be accommodated, Massarelli states. The success of these mitigation efforts has fortunately allowed City of Hope to lift the restrictions on platinum chemotherapy use, Massarelli concludes. However, the shortage continues to be a concern for many healthcare centers across the nation.