Wednesday, April 25, 2018

Drug shortage threatens success for young cancer patients, study says

Young cancer patients who couldn't get a key medicine because of a national drug shortage were more likely to suffer a relapse than others who were able to get the preferred treatment, doctors report. It's the first evidence that a long-standing drug-supply problem probably has affected cancer treatment results in specific patients.

The study involved more than 200 children and young adults with Hodgkin lymphoma, a blood cancer that can be cured nearly 80 percent of the time. But a drug shortage that has worsened since 2009 threatens that success rate, doctors said in Thursday's New England Journal of Medicine.

Hundreds of drugs, including sedatives, antibiotics, painkillers and cancer treatments, have gone in and out of short supply in recent years. Reasons include manufacturing and contamination problems, plant shutdowns, and fewer makers and lower profits for certain drugs, especially generics infused during surgery or cancer treatment.

Doctors sometimes substitute different drugs. But proving that the swaps led to poorer results has been tough.

The new study, led by Dr. Monika Metzger of St. Jude Children's Research Hospital in Memphis, focused on mechlorethamine. Doctors compared 181 Hodgkin lymphoma patients who received the drug to 40 who were given cyclophosphamide. Only 75 percent of those given the substitute stayed free of cancer for two years versus 88 percent who got the preferred treatment.

Abby Alonzo of Port St. Lucie was diagnosed with lymphoma three years ago, when she was 10. After eight weeks of treatment with the preferred drug, "she was doing wonderfully," said her mother, Katie Alonzo.

Then doctors ran out of it.

After four weeks on the substitute chemo, Abby's cancer returned and spread, her mother said. The child received high doses of chemotherapy and radiation and now seems cancer-free.

To find out a life-saving medicine isn't available is "very, very frightening," Katie Alonzo said.

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