Amidst advancements in treating cancer, oncologists face new challenge: drug shortages

DURHAM, N.C. -- Duke Cancer Center took on a festive atmosphere Wednesday, as it held its annual Survivorship Day celebration, the first time it's been held in person since the pandemic.

"The energy that you feel walking in the front doors, I think that says it all after a three-year hiatus. This silence that we are used to, to not have that today just gives you chill bumps to be able to walk through and meet people on a similar path is just so important," said Kristy Sartin, the Director of External Relations for the Duke Cancer Institute.

"After you get a bone marrow transplant, after one year they call it your re-birthday. So I just turned one, so it's so much fun. It's so exciting. We're actually throwing a party at my house to celebrate. This time last year, I was in the hospital. So today, to be on this side of the hospital, I can't even describe it. It's so wonderful," said Alexa Baltazar, who was diagnosed with leukemia in 2021.

Hundreds of people stopped by to learn about a variety of offerings and services, ranging from cooking lessons, massage, hair extensions, and therapy dogs. Since the event started fifteen years ago, there's been a series of advancements in treating cancer.

"Think about things like immunotherapy, think about cancer survivorship services. Cancer survivors are living longer and longer in the survivorship state post-treatment," Sartin said.

"So initially when I was diagnosed, we did chemo, so I did five rounds of inpatient chemo. So I was here at the hospital for that. But then it was deemed that I needed a bone marrow transplant. So luckily, my sister, my only sibling, was a perfect match for this. So we were so blessed with that. And prepping for the bone marrow transplant, I did a ton of chemo, a ton of radiation," Baltazar said.

Cancer death rates have dropped by 25% over the past 25 years, with President Biden setting a goal for a 50% drop over the next 25 years. In order to achieve that, doctors need all tools at their disposal. However, oncologists are reporting they are facing shortages of several important drugs.

"This is a public health crisis," said Dr. Angeles Alvarez Secord, a Duke Gynecologic Oncologist who serves as President of the Society of Gynecologist Oncology.

Secord said the group started hearing of shortages back in April, which largely impacted community centers and smaller infusion sites at first. Now, it's facing even larger providers across the country.

"For our cancers, ovarian, endometrial, cervical, vulvar, and vaginal cancers, the chemotherapy drugs, cisplatin, and carboplatin are the backbone of our frontline treatment," said Secord.

The FDA has reported shortages of 11 different types of drugs, impacting a variety of cancers. At Duke, in some instances, they've had to slightly reduce dosages and expand cycle times, efforts that still maintain effectiveness. Elsewhere, measures have been more drastic.

"You can tell the incredible amount of angst that these oncologists have when they have to tell patients that the life-saving drug that can treat their cancer is not available," Secord said.

The shortages are caused by several different issues, including a lack of generic options, supply chain logistics, and the bulk of raw materials necessary to create the coming from overseas. Tuesday, Secord was part of a group of doctors to meet with the House Cancer Caucus, calling on federal interaction to address these shortages.

"How can we incentivize manufacturers in the U.S. to make these drugs, whether it's pull incentives or tax incentives? So we need to do something to ensure that we can eliminate, not just decrease the risk of these drug shortages, but completely eliminate them," said Secord.

The FDA is allowing cisplatin, one of the drugs affected by the shortages, to be imported from China. Baltazar, who received some of the drugs now in limited supply, shared her reaction to the news.

"That is horrible. I mean, every day counts in terms of treatment for a cancer patient. I had a very aggressive leukemia. We started treatment the day I was diagnosed. Knowing that patients are having to wait because of these shortages, it's really heartbreaking," she said. "And I mean, I was on many of the drugs that have a shortage right now that would have delayed my treatment. I don't know how that would have affected my recovery, but I can't imagine going through that right now. And I hope that they can figure that out soon."