A recent study published in JCO Oncology Practice highlights the detrimental effects of drug shortages, specifically etoposide, on patient outcomes in extensive-stage small cell lung cancer (ES-SCLC). The retrospective review examined outcomes during a period of sustained etoposide shortage in Canada, lasting over two years from 2018 to 2020.
Impact on Patient Outcomes
The study revealed a significant negative impact on patient outcomes during the etoposide shortage. Patients experienced decreased progression-free survival and an increased rate of hospitalization. While alternative regimens exist, intravenous etoposide remains the preferred platinum partner for many oncologists due to its long-standing use and familiarity.
Etoposide in ES-SCLC Treatment
For decades, platinum doublet chemotherapy has been the backbone of first-line treatment for ES-SCLC. More recently, immunotherapy has been incorporated in combination with platinum doublet, based on the IMpower133 and CASPIAN trials. In the United States, etoposide is commonly used as the platinum partner.
The Need for Consistent Drug Supply
"The study clearly shows that drug shortages can be detrimental," said Vinay Gupta, MD, a hematologist/oncologist at Saint Luke's Cancer Institute in Kansas City, Missouri. "There have been multiple instances of drug shortages in oncology, and while there are workarounds, there is a lingering and legitimate concern that such shortages have a significant detrimental result. Overall, this emphasizes the need for remedial measures to ensure consistent drug supply in the future."
