Although there are a variety of drugs in the treatment of malignant tumors, targeted drugs and immunotherapy drugs have become very common, chemotherapy is still a very common treatment because both targeted drugs and PD-1 inhibitors have the problem of drug resistance. When resistance occurs, patients will have to use chemotherapy, which does not distinguish between normal and cancer cells, but only kills the population of cells that divide and proliferate actively, which can lead to some adverse reactions.
Cisplatin is a relatively common chemotherapy drug that is widely used in the treatment of a variety of solid tumors, such as bladder, lung, head and neck, and testicular cancer. There are some patients who have heard from cisplatin, but there is a lack of comprehensive evidence to confirm a correlation between the two. A recent report published in JAMA Oncology illustrates this situation, and I hope it will be helpful to you.
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1. The chemotherapy drug cisplatin affects the patient's hearing
To prove that a patient's hearing is affected, a thorough hearing evaluation (e.g., text test in noise, full-spectrum audiometry, and other otology exams) is required. This study is a longitudinal study of testicular cancer survivors who received cisplatin from 2012 to 2018 and are being followed up. Academics from Indiana University and Memorial Sloan Kettering Cancer Center enrolled a total of 100 participants.
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The median age of the 100 participants was 48 years (25 to 67 years old), and the median time after chemotherapy was 14 years. The results showed that after chemotherapy with cisplatin, 78% of patients experienced severe difficulties with daily hearing, negatively affecting their quality of life.
It is important to note that the ear is a more fragile organ because the ear has little ability to filter out the drug, which will cause the drug to become trapped in this organ, leading to inflammation, damage to sensory cells that are essential for encoding sound, which will cause permanent hearing loss, and may gradually worsen after cisplatin treatment is completed. But before this study, most patients did not receive hearing tests before and after chemotherapy, and even did not pay attention to hearing impairment.
2. What factors have a greater impact?
The team also found that the higher the dose of cisplatin used for chemotherapy, the more severe the hearing loss. In particular, patients with risk factors such as high blood pressure and poor cardiovascular health often do not have enough hearing in common settings, such as noisy restaurants.
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Researchers say it's crucial to follow these patients throughout their lives. The average age of the patients followed in this study was only 48 years old, and they will eventually enter the age of age-related hearing loss. The researchers also hope that this study will stimulate research into alternative chemotherapy regimens, such as drugs to prevent or reduce hearing loss. For example, Pedmark is a new FDA-approved injection that can reduce cisplatin-induced hearing loss in children.
In addition, the American Cancer Society said that in addition to cisplatin, other platinum-based chemotherapy drugs such as carboplatin can also cause damage to the cochlea of the inner ear, leading to hearing loss, and the higher the chemotherapy dose, the greater the risk of damage. In addition, for most solid tumors, it is difficult to completely cure by chemotherapy alone, and it is still necessary to find suitable targeted drugs through genetic testing, and with immunotherapy drugs for synergistic treatment, patients will benefit more and the adverse reactions will be reduced a lot.
The "Genetic Testing, Accessible to Everyone" public welfare program launched by Cancerology and Geinga has a minimum of 3,000 yuan to detect 50 genes of tumor targeted drugs, escorting targeted therapy for patients! You can pay attention to the WeChat public account of cancer or download the cancer app to consult cancer medicine.
Bibliography:
Victoria A. Sanchez et al, Comprehensive Audiologic Analyses After Cisplatin-Based Chemotherapy, JAMA Oncology (2024).