Vincristine Shortage: What Other Options We Have?

To the Editor: Vincristine is a widely used anticancer medication with Food and Drug Administration (FDA)-approved indications in the treatment of many cancers including acute lymphocytic leukemia (ALL), lymphoid blast crisis of chronic myeloid leukemia, and Hodgkin and nonHodgkin lymphoma.1 The Children’s Oncology Group (COG) has issued a letter to the Childhood Cancer Community sharing information about vincristine shortage. COG stated that Pfizer/Hospira, now the sole supplier of vincristine in the United States, is experiencing a shortage of the drug due to a manufacturing delay. Teva Pharmaceuticals, another manufacturer of vincristine in the United States, made a “business decision” and stopped supplying the drug to the United States in July of 2019.2 The COG also provided guidance for changing treatment protocols to compensate for drug shortages, but, with vincristine, the options are basically delaying, cutting, or skipping doses. Thus, there is an urgent need to investigate other options to identify an appropriate alternative that can safely and effectively substitute vincristine in such scenarios.