Pediatric cancer drugs in short supply

As the supply of two staple cancer drugs rebounds after months of scarcity, two medications used in pediatric cancer patients have fallen into shortage, NBC News reported Sept. 25. 

The shortages of cisplatin and carboplatin are easing, but methotrexate access remains in flux, and supply levels of vinblastine and dacarbazine are worsening. 

Vinblastine is approved to treat Hodgkin lymphoma, non-Hodgkin lymphoma, Kaposi sarcoma, and breast and testicular cancer; dacarbazine is used for melanoma and Hodgkin lymphoma. Both are in shortage, and pediatric providers are worried because there are few alternatives.

Vincristine can be used as a replacement, but it can be less effective and present more side effects, according to NBC News. And for older children with Hodgkin lymphoma, a four-drug regimen is standard practice, so the current shortages could affect patient care. 

There are no available solutions of vinblastine, as Fresenius Kabi's 1 milligram per milliliter, 10 milliliter dose vials are on back order, according to the American Society of Health System Pharmacists. The drugmaker expects the shortage to ease between mid- and late September. The FDA advises healthcare workers to check wholesalers for inventory.

For dacarbazine, three drugmakers have solutions on back order or allocation, and no solutions are at normal supply levels, according to the ASHP.

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