Cancer therapy-induced ototoxicity: Current challenges and emerging management strategies

Area of Science:

• Ototoxicity research
• Cancer treatment side effects
• Auditory and vestibular science

Background:

• Cochleovestibular impairment, a consequence of cancer interventions, leads to sensorineural hearing loss and vestibular dysfunction.
• Ototoxicity negatively impacts cognitive health and quality of life, with current detection and prevention methods being suboptimal.
• Risk factors include age, genetic variations, and cumulative dosage from chemotherapy, radiotherapy, and immunotherapy.

Purpose of the Study:

• To comprehensively review the molecular pathogenesis and risk factors of ototoxicity in cancer patients.
• To evaluate cellular mechanisms of cisplatin-induced inner ear damage.
• To critique current monitoring protocols and advocate for enhanced audiological screening standards.

Main Methods:

• Literature review of molecular pathogenesis and risk factors.
• Analysis of cellular mechanisms of ototoxicity, particularly cisplatin effects.
• Critique of existing clinical monitoring protocols for hearing and balance dysfunction.

Main Results:

• Identified key risk factors and molecular pathways contributing to ototoxicity.
• Detailed cellular damage mechanisms in the stria vascularis and hair cells.
• Highlighted limitations in current clinical monitoring and proposed improved audiological assessments.

Conclusions:

• Emphasizes the need for improved early detection and prophylactic interventions for ototoxicity.
• Advocates for integrating baseline and high-frequency audiological screening into standard cancer care.
• Promotes a precision-medicine approach to preserve auditory integrity while optimizing cancer treatment efficacy.