The state of the bladder cancer drug shortage and its effect on treatment

In this video, Scott Tagawa MD, Weill Cornell Medicine, discusses the current status of the cisplatin and carboplatin shortage in bladder cancer and how physicians and patients are adapting to the situation.

Transcript

Regarding how serious the issue is, it depends on your region. There are certain regions that, I hear, had no carboplatin a couple of months ago, with some availability of cisplatin. And then sometimes a new batch will come out, and the people will be covered for a period of time. I would refer people, essentially on a daily/weekly basis—because they are being updated in real time—to the FDA website or the ASCO website, that will have updates, both in terms of availability—so when there's a new lot that comes out—and in terms of guidance since there are about 10 different disease settings for which there is more specific guidance, including bladder cancer.

The basic guidance is when the goal is cure, we really need certain drugs; and for urothelial cancer that is cisplatin….So, [for the most part] we are kind of stuck [in a situation] when there is no cisplatin. At that point, the patient travels to another region to get it or we just go with upfront surgery and then kind of re-evaluate at [that point] and see if there is platinum available for adjuvant therapy or do adjuvant immunotherapy if that’s applicable for that particular patient. For metastatic disease, luckily there’s enfortumab vedotin plus pembrolizumab if that’s appropriate for the patients, but that’s on a case-by-case basis. As the updates come in terms of availability and as the evidence changes, then I would expect that the ASCO website to be updated.

Transcript has been edited for clarity.