Oncologists warned that chemotherapy shortages are forcing substitutions and workarounds that can compromise care. The report highlights supply constraints for several critical generics, including carboplatin, cisplatin, oxaliplatin and ifosfamide, with the FDA estimating ifosfamide injection formulations may remain in shortage until at least October 2026. Clinicians described strategies such as prioritizing patients with curative intent, using alternative therapies when possible, and stretching vial use through lower-end dosing or scheduling consecutive patients. However, they emphasized these approaches are “not ideal,” especially for tumors like testicular cancer that are sensitive to cisplatin. — Key takeaway: the shortage is portrayed as both a clinical and pricing-model problem, increasing the risk that some patients cannot receive life-saving drugs.