Drug shortage could delay treatments for children with cancer

Published: Oct. 17, 2019 at 10:32 PM CDT
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Some children with cancer are having their treatments changed, or delayed because of a shortage of a widely-used chemotherapy drug.

Kelsi Flowers of Topeka admitted the situation is "a little frustrating."

Flowers' four-year-old daughter Laykn is fighting leukemia. Diagnosed just over a year ago, she's in remission, but still in the maintenance phase of chemotherapy.

Her next treatment at Children's Mercy is set for December, but could be delayed if a nationwide shortage of the common childhood chemo drug Vincristine continues. Flowers said their doctor reached out to them this week to explain how it will be reserved for the children in initial treatment.

"Of course you know I want my daughter to have the best treatment she can. (butt) to me, it is more important that a child who is still currently fighting and has active leukemia would receive it," Flowers said.

One of two U.S. manufacturers of Vincristine - Teva Pharamcuetical - stopped making it in July. The remaining provider, Pfizer, has ramped up production, and expects to ship its first additional doses by the end of the month. But the shortage could continue until January.

"This will affect kids with cancer," said Dr. Youmna Othman, pediatric oncologist at Cotton O'Neil Cancer Center in Topeka. "It's not fair."

Dr. Othman said Vincristine is part of nearly every drug combination used for pediatric and young adult cancer patients. Stormont Vail in Topeka should have enough for at least the next month. If the shortage stretches much longer, or they get an unexpected influx of new patients, Dr. Othman says they may be forced to manage doses by swapping in other drugs when possible, or delaying doses.

"The studies are made based on giving it at certain times, so we don't know (the possible impact)," she said. "It's an extra risk we're putting on these patients. As a mom, as a doctor, it's very scary to think about telling people I can't give it, or your child needs it but I'm going to stretch it out a couple days. That's what we're gonna have to do."

Dr. Othma says there are drugs similar to Vincristine, but none studied in the combinations in which these would be used. In addition, there are not many other options when it comes to pediatric patients, because it is difficult to do trials and gain new approval for new drugs for the younger population.

Both Dr. Othman and Flowers agree the situation highlights the need for more research on pediatric cancer, so families have more options.

"I hope this brings more awareness to the fact that there are multiple children even in just Topeka that are fighting," Flowers said.

A spokesperson for Children's Mercy, where Lakyn is being treated, said they are "following national guidance and identifying those settings where managing doses of Vincristine can be most successfully accomplished with the least impact on outcome.

They say they also are reaching out to patients and families, and encouraging any who have questions to contact their providers.

13 NEWS also reached out to the Food and Drug Administration. A spokesperson said the agency is working closely with Pfizer, and "exploring all options to make sure this critical cancer drug is available for the patients who need it."