Balancing the Benefit and Toxicity of Cisplatin in Young Children with Cancer

Cisplatin is a life-saving drug, says Bruce Carleton, PharmD, FCP, FISPE. While the drug has life-saving benefits, it also causes some degree of hearing loss in about 60% of children who receive this therapy. In addition, about 40% of children who receive cisplatin will need hearing aids for the rest of their lives as a result of the treatment.

On this episode of “The Vitals,” Carleton, of the Department of Pediatrics, Division of Translational Therapeutics at the University of British Columbia, spoke to Oncology Nursing News® about balancing the beneficial effects of cisplatin with the potential to cause permanent hearing loss, in children with solid tumors. He discusses a study he recently co-authored whose findings indicate that this treatment puts children under 5 at an increased risk of hearing loss compared to children over 5, as well as comments on how genetics may someday play a role. in reducing the risk of hearing loss in this patient population.

The study assessed 368 pediatric cancer patients by performing more than 2,000 audiological assessments before, during, and after cisplatin treatment. Three years after initiation of treatment, 75% of patients 5 years of age and younger and 48% of patients older than 5 years of age had hearing loss caused by cisplatin. According to Carleton, these findings demonstrate the need for routine audiological assessments for children receiving this treatment.

“At the end of each cycle we must [conduct] a hearing assessment, and we need to monitor the toxic course of this drug,” he says. “The legitimate concern of some clinicians is that if patients or parents know that their child is developing hearing loss, they are more likely to say, ‘Do we really have to give them cisplatin? ?'”

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