1732P - War and the fragility of anticancer drug supply networks in Ukraine

Background

Systemic therapy availability in Ukraine is fluid due to the war. This information is key to optimizing cancer care.

Methods

Online surveys assessing cancer treatment capacity were distributed to physicians in Ukraine through cancer-focused social media in April 2023. Results were analyzed with descriptive statistics and Fisher’s exact test.

Results

15 oncologists from 14 oncology centers and 12 hematologists from 9 hematology centers completed surveys, including 3 (25%) and 4 (27%), respectively, from the more war-affected Northern, Southern, and Eastern Ukraine. Of the 36 drugs used for solid tumors, limited availability (half of the time, rarely available, or unavailable) was reported for 11 (31%) drugs by 2-4 (14-29%) respondents: cisplatin, cyclophosphamide, doxorubicin, etoposide, fluorouracil, ifosfamide, methotrexate, vincristine, filgrastim, dexamethasone, tamoxifen. 7 (19%) had limited availability per 5-6 (36-42%): capecitabine, irinotecan, mesna, anastrozole, leuprolide, zoledronic acid, erlotinib. 12 (33%) drugs were limited per 7-8 (50-57%): abiraterone, bleomycin, carboplatin, docetaxel, gemcitabine, oxaliplatin, paclitaxel, vinblastine, vinorelbine, folinic acid, bicalutamide, trastuzumab. 7 (19%) were limited per 8-13 (57%-93%): nivolumab, diethylstilbestrol, bevacizumab, palbociclib, trastuzumab emtansine, sorafenib. Of 31 drugs used for hematologic malignancies, 4 (21%) were limited in availability per 2-4 respondents: vincristine, bortezomib, imatinib, azacitidine. 5 (16%) were limited per 5-6: bendamustine, filgrastim, doxorubicin, lenalidomide, hydroxycarbamide. 10 (32%) were reported to be limited by 7-8: rituximab, thalidomide, vinblastine, chlorambucil, bleomycin, methotrexate, daunorubicin, nilotinib. 10 (32%) were limited per 9-12: ibrutinib, mercaptopurine, eltrombopag, erythropoietin, thrombopoietin, ruxolitinib, venetoclax, brentuximab, gemtuzumab, obinutuzumab. Drug availability did not differ by country region (p > 0.05).

Conclusions

Shortages of essential anticancer drugs are a continued challenge in Ukraine during the war. Results are limited by small sample size and limited sampling from regions affected by active hostilities.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.