4 cancer drugs in short supply, some resupply dates in summer

At least four oncology drugs are in shortage, and some drugmakers don't expect supply levels to recover until mid-2023. 

The four drugs concerning clinical pharmacists are injectable methotrexate, cisplatin, fluorouracil and Pluvicto (injectable lutetium vipivotide tetraxetan), the Center for Infectious Disease Research and Policy reported March 16. 

1. Methotrexate is a treatment for acute lymphoblastic leukemia, breast cancer, lung cancer, and certain types of head and neck cancer, according to the National Cancer Institute. Some solutions have been unavailable for months, and currently, there are 11 products on back order and one available, according to the ASHP. Resupply dates range from March to July. 

2. Older chemotherapy drug cisplatin has seen a recent restock, drugmakers told the ASHP. Its label use is for bladder cancer, but it is also prescribe off-label for "squamous cell head and neck cancer, cervical cancer, lung cancer, osteosarcoma, esophageal cancer, adrenal cortex carcinoma, breast cancer, endometrial cancer and liver cancer," the ASHP said.

3. Fluorouracil, also known as 5FU, is commonly used with newer chemotherapy drugs, and there are no available products. Most resupply dates hover around April, and one solution is expected to return to normal supply levels in June. 

4. Novartis makes Pluvicto in small batches in Italy and is awaiting the FDA's approval for two production sites in the U.S. The FDA reported the shortage of the advanced prostate cancer treatment on March 7 and said it's the result of delivery issues. In a letter to patients, the drugmaker said it will prioritize supply to those currently in their treatment process. 

"As we endeavor to provide patients who have received one or more doses with their full treatment course, patients who are currently in our scheduling system and awaiting their first doses will need to be rescheduled," Novartis said in the letter. "In the same spirit, we will not be able to take any new orders until we have clarity on the FDA's approval of one of our new sites (expected within the next four to six months)."

Jonathan McConathy, MD, PhD, director of the division of molecular imaging and therapeutics at the University of Alabama at Birmingham, told The Wall Street Journal, "People will die from this [Pluvicto] shortage, for sure," since new patients won't be able to immediately start the treatment.

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