Related Experiment Video
Updated: Sep 26, 2025
Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
Published on: March 16, 2018
Ototoxicity Review: A Growing Number of Non-Platinum-Based Chemo- and Immunotherapies
James G Naples1, Wyatt Rice-Narusch1, Nathan W Watson2
1Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA.
Objective:
To raise awareness of the growing list of non-platinum-based chemo- and immunotherapeutic agents that have been associated with ototoxicity and to introduce the possible mechanism of ototoxicity of these agents.
Data Sources:
PubMed, Embase, and Web of Science.
Review Methods:
A systematic review was performed following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses). PubMed, Embase, and Web of Science databases were searched for published reports of ototoxicity from non-platinum-based chemo- and immunotherapeutic agents in adult and pediatric patients. Therapies that utilized any platinum-based agent were excluded.
Conclusions:
Ototoxicity from non-platinum-based chemo- and immunotherapies is an evolving problem. There were 54 reports-39 case reports and 15 cohort studies-documenting ototoxicity from 7 agents/combination therapies. Of these reports, 37 (69%) were published within the last 15 years (after 2005). No recovery of hearing was documented in 21 of 56 cases (38%). Pretreatment audiograms were uncommon (19/54 studies, 35%), despite documented ototoxic associations.
Implications For Practice:
There is a growing number of novel, ototoxic, non-platinum-based chemo- and immunotherapeutic agents with various potential mechanisms of action. Otolaryngologists will need to prioritize awareness of these agents. This growing list of agents, many of which have reversible effects, suggest a need for standardized ototoxicity monitor protocols so that appropriate and timely management options can be implemented.
Insights
Awareness of ototoxicity from non-platinum chemotherapy and immunotherapy is crucial, as new agents emerge. Standardized monitoring protocols are needed to manage hearing loss from these treatments.
Area of Science:
- Ototoxicity research
- Chemotherapy and immunotherapy side effects
- Otolaryngology
Background:
- Growing number of non-platinum-based chemotherapy and immunotherapy agents are linked to ototoxicity.
- Ototoxicity is an evolving problem with significant implications for patient hearing health.
- Understanding potential mechanisms of ototoxicity is essential for management.
Approach:
- Systematic review adhering to PRISMA guidelines.
- Searched PubMed, Embase, and Web of Science for ototoxicity reports.
- Excluded studies involving platinum-based agents.
Key Points:
- 54 reports documented ototoxicity from 7 non-platinum agents/combinations.
- 69% of reports were published after 2005, indicating a recent increase.
- 38% of cases showed no hearing recovery, and pretreatment audiograms were infrequent.
Conclusions:
- Novel ototoxic non-platinum agents require increased clinician awareness.
- Standardized ototoxicity monitoring protocols are necessary for timely intervention.
- Effective management strategies are needed for hearing loss associated with these therapies.
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