Dr Wander on Using Platinum Chemotherapy Wisely in Breast Cancer

Seth Wander, MD, PhD, medical oncologist, Massachusetts General Hospital; instructor, medicine, Harvard Medical School, discusses challenges related to the ongoing platinum chemotherapy shortage for patients with breast cancer and other malignancies, as well as ways that oncologists and cancer centers can operate during the shortage to continue to provide appropriate care for patients.

In June 2023, the National Comprehensive Cancer Network released a statement with results from a survey conducted by its Best Practices Committee, revealing that 93% and 70% of cancer centers in the United States are experiencing carboplatin and cisplatin shortages, respectively. 

This platinum chemotherapy shortage affects the management of several tumor types, as platinum agents are often used in both early-stage and metastatic settings, Wander says. For example, within the breast cancer realm, patients with early-stage HER2-positive or triple-negative breast cancer often receive carboplatin as preoperative chemotherapy, Wander notes.

This drug shortage affects patients and cancer centers across the United States and requires daily decision making by oncologists, Wander explains. The oncology community, in collaboration with the United States government, should work together to develop a safe solution to this shortage as quickly as possible, so patients with cancer who are eligible for platinum chemotherapy can have uninterrupted access to appropriate treatment, Wander emphasizes.

In response to this shortage, oncologists at cancer centers across the country, including Massachusetts General Hospital, are making thoughtful decisions about when they use platinum chemotherapy, he says. Administration of carboplatin and cisplatin is being prioritized for when they are critical for a patient’s care and cannot be safely replaced with an alternative treatment, Wander says. As every patient has unique treatment needs, oncologists need to consider all available standard therapeutic options in case there are regimens beyond platinum chemotherapy that are equally effective and safe for a given patient, Wander explains.

As the chemotherapy shortage continues to evolve, the availability of these drugs will fluctuate, Wander notes. In the future, the leadership teams at cancer centers across the country may need to develop policies to guide oncologists in the safe and effective distribution of platinum chemotherapy, Wander concludes.