Repurposed Drug May Help Preserve Hearing of Children Taking Cisplatin

AN ANTIOXIDANT APPROVED FOR use as an antidote to cyanide poisoning may also prevent hearing loss, a potential side effect of the chemotherapy drug cisplatin, in children who take the anticancer drug.

That finding came out of a European study published June 21 in the New England Journal of Medicine.

The study included 57 children with localized liver cancer known as hepatoblastoma who were being treated with cisplatin. They were given the cyanide antidote, sodium thiosulfate, six hours after each treatment; meanwhile, 52 children with the disease took cisplatin alone.

Among 101 evaluable patients, children who took the antioxidant had a 48 percent lower incidence of hearing loss than those who did not: Hearing loss of grade 1 or higher occurred in 18 of 55 children in the sodium thiosulfate group, compared with 29 of 46 in the cisplatin-alone group.

Taking sodium thiosulfate did not interfere with cisplatin’s effectiveness. Three-year rates of survival without worsening disease were 82 percent in the cisplatin plus sodium thiosulfate group and 79 percent in the cisplatinalone group, and three-year overall survival rates were 98 percent and 92 percent, respectively.

“Around 60 percent to 80 percent of kids who get cisplatin have significant hearing loss,” trial senior author Edward Neuwelt, M.D., of Oregon Health & Science University, told Cancer Currents, a blog published by the National Cancer Institute.

Side effects of sodium thiosulfate included nausea, vomiting and reduced blood cell numbers, according to the blog.

Future studies will look at ways to predict which patients will respond to sodium thiosulfate, whether the drug is safe for children whose cancer has spread and whether it can help children with medulloblastoma, for whom cisplatin-related hearing loss is a big concern.