During the 2023 International Lung Cancer Congress, 

® asked experts from the lung cancer field to discuss the challenges of the ongoing cisplatin and carboplatin shortages in the United States and detail how they are adapting in their practices.

Karen L. Reckamp, MD, MS, professor of medicine, director, Division of Medical Oncology and Lung Institute at Cedars-Sinai Medical Center and associate director at Clinical Research, Cedars-Sinai Cancer Institute

Edward Kim, MD, MBA, physician-in-chief at City of Hope Orange County and vice physician-in-chief at City of Hope National Medical Center

Heather Wakelee, MD, professor of medicine and chief of the Division of Oncology at Stanford University School of Medicine; deputy director and division chief of Medical Oncology at Stanford Cancer Institute; and president of the International Association for the Study of Lung Cancer

Edgardo Santos MD, FACP, FCCP, clinical affiliate associate professor at Florida Atlantic University and treasurer of the Florida Society of Clinical Oncology

Lyudmila Bazhenova, MD, medical oncologist and professor of clinical medicine at the University of California San Diego Moores Cancer Center

A survey conducted by the National Comprehensive Cancer Network Best Practices Committee published in June 2023 showed that 93% of the 27 United States cancer centers polled were experiencing a shortage of carboplatin, and 70% were facing a shortage of cisplatin. The survey showed that 100% of cancer centers were still able to treat patients who need cisplatin without any delays or claim denials; however, only 64% of centers reported being able to keep all patients who were receiving carboplatin on their current regimen. Additionally, 20% of surveyed institutions shared that they could continue this prescription for some but not all patients.

In April 2023, the Society of Gynecologic Oncology (SGO) recommended that clinical practices minimize ordering non-essential platinum chemotherapy, increase the interval between cycles, and reduce the total platinum dose when clinically acceptable. They also recommended that practices consider minimizing or omitting cisplatin or carboplatin for patients with recurrent platinum-resistant ovarian and other cancers and round doses down to the nearest vial size to ensure efficient use. Lastly, it was stated that platinum-based chemotherapy be reserved for curative-intent treatment or for patients in whom prolonged clinical benefit is anticipated.

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Experts discuss the challenges of the ongoing cisplatin and carboplatin shortages in the United States and detail how they are adapting in their practices.

Lung Cancer Experts Detail Challenges of Cisplatin/Carboplatin Shortages

Lyudmila Bazhenova, MD, professor of clinical medicine, University of California, San Diego, discusses the potential approval of lorlatinib for patients with 

-positive non—small cell lung cancer (NSCLC).

Lorlatinib data are only relevant for patients who have failed prior ALK inhibitors, says Bazhenova. The study of lorlatinib had a treatment-naïve cohort, so physicians should have an idea of how lorlatinib works in patients who have not been exposed to alectinib (Alecensa) or crizotinib (Xalkori). The randomized trial results have not been released yet, says Bazhenova.

Lorlatinib is running a head-to-head study against crizotinib, and it is very possible that in the future physicians may have another option for newly diagnosed patients. Bazhenova notes that the trial design of lorlatinib is very important. It had several cohorts, and some of the cohorts allowed patients who had received 2 or more prior ALK inhibitors. Physicians have some sense that lorlatinib could work following treatment with brigatinib (Alunbrig), alectinib, or ceritinib (Zykadia).

Lyudmila Bazhenova, MD, professor of clinical medicine, University of California, San Diego, discusses the potential approval of lorlatinib for patients with ALK-positive non–small cell lung cancer (NSCLC).

Lyudmila Bazhenova, MD

Articles

Lung Cancer Experts Detail Challenges of Cisplatin/Carboplatin Shortages

Dr. Bazhenova on the Potential Approval of Lorlatinib for Patients With ALK-Positive NSCLC