Cancer journal最新文献

Purpose/background: Cancer drug shortages adversely affect cancer patient care and ultimately cancer patient lives. Shortages of cancer drugs used for pediatric cancer patients are well described.

Methods: Review of published literature, news reports, and grey literature on cisplatin and carboplatin shortages.

Results: The shortages were multifactorial-reflecting supply chain disruption, limited redundancy in manufacturing, and dependence on out-of-country sources for injectable generic oncology drugs.

Discussion: This report of carboplatin and cisplatin shortages extends concerns noted earlier with pediatric oncology drug shortages. Improvements in supply chain and consideration of on-shoring manufacturing is needed.

The issue of drug shortages is a persistent and complex one. There is an urgent need for a wide-ranging, multifaceted strategy to address drug shortages and bold, comprehensive solutions. Professional societies, such as the American Society of Clinical Oncology (ASCO), have a crucial role to play in advocating for governmental action and raising awareness to combat these critical shortages of lifesaving and life-prolonging medications. ASCO's proposed solutions focus on reforming economic incentives related to generic drug pricing to foster market sustainability and encourage investment in high-quality manufacturing. This will require significant collaboration, including government intervention and public-private partnerships.

Drug shortages continue to pose a serious threat to health care systems worldwide, often depriving patients of essential, life-saving medications. This article presents the patient perspective on drug shortages through the work of Laura Bray, founder of Angels for Change-a nonprofit committed to ending drug shortages through advocacy, awareness, and supply chain resilience. Inspired by her personal journey when her daughter's cancer treatment was nearly derailed by a shortage, and informed by her professional background in supply chain management, Bray launched a grassroots movement that now connects patients, providers, manufacturers, supply chain leaders, and policymakers. The article explores Bray's belief in a patient-centered supply chain, her creation of the Drug Shortage Hotline, and her collaborative, multi-stakeholder approach to systemic change. It also highlights the industry and policy reforms she champions to prevent future shortages and create a more reliable pharmaceutical system. Through the lens of Angels for Change, the piece illustrates the transformative power of patient advocacy and cross-sector cooperation in addressing one of health care's most urgent challenges.

Oncology drug shortages have reached unprecedented levels and have had a substantial impact on the treatment of cancer patients, which can include medication rationing, delayed treatments, and inferior therapeutic substitutions. This manuscript outlines systemic drivers of supply chain vulnerabilities that lead to drug shortages, presents medicines supply chain data analyses of ongoing shortages, and proposes actionable policy reforms for advocacy to address patient needs and build resilience and sustainable change in the pharmaceutical supply chain.

Shortages of oncology medications have unique complications for dedicated cancer centers and comprehensive cancer centers. Mitigation solutions for medication shortages at these types of health systems can help extend supply and decrease existing demand run rates, but these shortages can eventually lead to suboptimal patient outcomes. Health care's collective focus should be on ending drug shortages, not mitigating them.

Drug shortages remain a problem in the United States, jeopardizing patient care. To help inform solutions, this study reviewed recent oncology drug shortages for causes and mitigation strategies. Using the FDA's Drug Shortage Database, 15 oncology drugs with shortages between 2023 and 2025 were identified. Twelve drugs had shortages lasting >2 years (maximum: >13 y). Searches of PubMed and Google Scholar, online media sources, and FDA documents uncovered 9 main causes: manufacturing quality problems, limited-source dependency, regulatory bottlenecks, global over-reliance, absence of buffer stocks, demand surges, low economic incentives, active pharmaceutical ingredient shortages, and shelf-life constraints. Mitigation strategies involved 4 stakeholders: regulators (expedited regulatory action, importation, expiration extensions), manufacturers (capacity expansion), providers (dose-sparing regimens, therapeutic alternative protocols, allocation prioritization), and purchasers-distributors including GPOs (supply collaboration). Policies to mitigate drug shortages should include new approaches to identify vulnerable markets and involve multiple stakeholders. Factors identified in this study also offer pathways for shortage prevention.

Despite continued efforts, pediatric oncology patients face, at times, insurmountable barriers to cancer medication access, creating an ongoing public health crisis with potentially tragic consequences. These shortages adversely impact pediatric patients in the United States and their ability to complete pivotal drug regimens. Resource availability and accessibility are exacerbated by a lack of oversight and predictability in the practices of manufacturers, distributors, and hospitals. In this review, we specifically examined the impact of current drug inventory practices within hospitals and subsequently developed recommendations for implementing pediatric cancer drugs into Strategic National Stockpiles for a more regulated approach to drug distribution.

The Trump Administration has signaled its intent to impose tariffs on pharmaceuticals worldwide, raising uncertainty about the potential impact on cancer treatments in the United States. Increasing concern surrounds the possibility that these tariffs may compromise the quality of care and adversely affect the survival outcomes of cancer patients across the country. The proposed tariffs on pharmaceuticals threaten to worsen already high drug costs and disrupt access to essential cancer treatments. As Martha Basey of Patients for Affordable Drugs points out, "We know that already one in three people in the United States can not fill their prescriptions because of high costs. We expect the pharmaceutical companies not to let this chaos over trade go to waste Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation and try to raise prices while pointing the finger at tariffs." Given the complex global supply chain and existing drug shortages, tariffs risk increasing prices without encouraging more domestic production or improving patient care. For these reasons, policy experts strongly caution against imposing broad tariffs on cancer medicines and advocate for alternative solutions to protect access to and affordability of these medications.

This review article explores the role of immuno-radiotherapy in the context of genome instability and tumor evolution. Genomic changes in tumors exist in a delicate balance with the immune system, offering evolutionary pathways to adapt and grow but risking provoking an immune response. Rapid developments across both immunotherapy and radiotherapy have raised questions about the potential benefits combination therapy, and how best to identify ideal treatment populations. Here we discuss foundational studies of genomic instability and tumor evolution, how these paradigms translate into immune surveillance and evasion, and subsequently go on to explore recent preclinical and clinical studies of both treatment modalities. Understanding how cancers evolve in the context of the immune system could provide a key insight in delivering better therapies that could overcome treatment resistance.