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Pediatric Cancer Drugs Hit by Shortages

While supplies of commonly used cancer drugs like carboplatin and cisplatin have eased since shortages were reported earlier this year, pediatric cancer doctors now report shortages in drugs used to treat blood cancers in children. These include vinblastine and dacarbazine used to treat Hodgkin lymphoma and methotrexate used for acute lymphoblastic leukemia, the most common cancer in children. Because of the shortages, many doctors must delay treatment or substitute other drugs that might not work as well or have different side effects. The Biden administration took steps to increase the supply of carboplatin and cisplatin earlier in the year and has been working with some success to increase the supply of methotrexate since it was reported in March. But in September methotrexate was in short supply and new shortages were reported in vinblastine and dacarbazine. The shortages have forced hospitals to make adjustments in how they order medicines. “They’re trying to stay three steps ahead,” hematologist-oncologist Anders Kolb, president and CEO of the Leukemia & Lymphoma Society told NBC News. “It’s not like if you run out of something, just plug it into Amazon and it shows up the next day.”

‘Power Dynamics’ Play a Role in Women’s Cancer Care Globally

A report on women, cancer and power released Sept. 26 in the Lancet details how gender inequality affects cancer incidence and care for women around the world. The report states that, “Patriarchy dominates cancer care, research, and policy making, with men overrepresented in leadership positions in hospitals, treatment centers and research institutes.” Ophira Ginsburg, a medical oncologist and senior adviser at the National Cancer Institute Center for Global Health, is on the commission that generated the report. “The truth is in many ways and many places, women have very little choice to obtain care, even if care is available, even if poverty isn’t the primary issue, because of power dynamics,” she told STAT. Ginsburg cited screening for cervical cancer and HPV as an example. “If women could just get screened for cervical cancer and HPV, they wouldn’t get cervical cancer,” she said. “But how can they access care if governments don’t prioritize them, if companies are not brought to the table to lower prices for highly effective screening that we have, and girls don’t have the opportunity to receive the vaccine?” The Lancet report details several steps global leaders, scientists and clinicians can take to address the gender imbalance. “Gender bias, racism, and other forms of discrimination in cancer research and knowledge production can be addressed by creating awareness, ensuring equitable access to research opportunities and resources, and by implementing policies mandating that sex and gender dimensions are considered in research and policy making,” the report stated.

It’s Time to Catch up on COVID-delayed Cancer Diagnoses

A report jointly released by national cancer organizations and government agencies Sept. 27 in Cancer revealed that the number of diagnoses for three treatable cancers—thyroid cancer, breast cancer in women, and colorectal cancer—fell to less than half the expected level in April 2020, the first full month of the COVID-19 pandemic restrictions in the United States. The number of diagnoses dropped significantly for six cancer sites: breast, lung, colorectal, prostate, pancreas and thyroid, the report found. Oncologist Lisa Richardson, director of the Division of Cancer Prevention and Control for the Centers for Disease Control and Prevention, told CNN that nearly 10 million cancer screenings were missed at the beginning of the pandemic. Despite cancer screening and care returning to pre-pandemic levels, the number of screenings is still down nearly 10 million from what it would have been without the pandemic, she said. “But now it’s time for you to come back in to get these things done,” she said of the need to resume cancer screening. “Cancer doesn’t wait, neither should you.” According to Chris Alban, a clinical informaticist at Epic Research, the jury is still out on whether missed screenings have resulted in worse patient outcomes, “though we plan to monitor this trend to see whether it holds over time,” he said in the CNN report. “The recommended intervals between screenings for a given cancer can be several years, so evidence of advanced cancers can take a long time to appear.”