Sodium thiosulfate reduces the risk of hearing loss owing to cisplatin-based chemotherapy in children with hepatoblastoma, a study published in the New England Journal of Medicine (21 June 2018) has shown
Researchers randomly assigned 109 children (median age 13 months) with standard-risk hepatoblastoma to either cisplatin alone or cisplatin with an infusion of sodium thiosulfate six hours later. All patients received four pre-operative and two postoperative courses.
At median follow-up of 52 months, the risk of hearing loss was 48% lower in the sodium thiosulfate group. Hearing loss, assessed according to the Brock grade, of grade 1 or higher occurred in 63% of those who did not receive sodium thiosulfate, compared with 33% of those who did.
Rates of three-year event-free and overall survival were similar between the two groups.
The researchers explained that cisplatin-based therapy is very effective in hepatoblastoma but frequently causes hearing loss. This can be particularly damaging to development in younger children.
“We found that the delayed administration of sodium thiosulfate resulted in a significantly lower incidence of cisplatin-induced hearing loss, with no evidence of tumour protection,” they concluded.
Sodium thiosulfate is not yet licensed in the EU but has received a breakthrough therapy designation from the US Food and Drug Administration.