Early Detection of Ototoxicity Using Serial Mobile Audiometry, Otoacoustic Emissions Testing, and Inner Ear Biomarker Measurement in Patients Receiving Platinum-Based Chemotherapy Treatment: It is Feasible to Implement in a National Health Service (NHS) Cancer Ambulatory Care Setting.

IMPORTANCE

Platinum-based chemotherapy is widely used in the management of solid tumors, and up to 60% of patients will experience ototoxic side effects, including hearing loss and tinnitus. The advent of novel otoprotective drugs generates a need for more flexible and innovative real-time approaches to drug-induced ototoxicity monitoring in cancer patients.

OBJECTIVE

To assess the feasibility of recruitment and compliance to monitoring of ototoxicity with mobile out-of-booth audiometry, Distortion Product Otoacoustic Emission (DPOAE) testing, and serum biomarker measurements.

DESIGN

Prospective observational study.

SETTING

Cancer ambulatory care.

PARTICIPANTS

Patients undergoing platinum-based chemotherapy for bone or testicular cancer.

RESULTS

Twenty-three patients were enrolled between February 2021 and June 2023. The mean age was 17.5 years (range: 13 to 36 y). Average compliance to monitoring assessments was 86.5% for audiometry, 84.8% for DPOAEs, and 84.3% for serum biomarker measurements. End-of-treatment audiometric changes indicative of ototoxicity were found in 18 (78.2%) of the participants.

CONCLUSIONS AND RELEVANCE: High compliance with serial mobile audiometry and otoacoustic emissions testing, and serum biomarker measurement suggests that ototoxicity monitoring can be successfully performed in cancer ambulatory care rather than in an audiology department setting. Further investigation is required to understand the role of serum prestin and otolin-1 in monitoring ototoxicity.