High prevalence of cisplatin-induced ototoxicity in Cape Town, South Africa

Whitehorn, Heather; Sibanda, Mkhonzeni; Lacerda, Miguel; Spracklen, Timothy; Ramma, Lebogang; Dalvie, Sameera; Ramesar, Raj

doi:10.7196/samj.7389

Cited by 31 publications

(31 citation statements)

References 17 publications

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“…[16] Cisplatin, a commonly used antineoplastic drug, is known to cause irreversible dose-dependent ototoxicity [6,17] leading to HFSNHL. Noise exposure may result in a three-fold increased risk of hearing loss with cisplatin.…”

Section: Chemotherapymentioning

confidence: 99%

“…There are currently few screening programmes for high-risk groups in the developing world. [5] High-risk groups include the elderly and patients receiving potentially ototoxic medications: chemotherapeutic agents, [6] second-line antituberculosis (TB) regimens and antiretrovirals (ARVs). [1,7,8] These groups are at risk of developing high-frequency hearing loss, as explained below.…”

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confidence: 99%

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Hearing loss in the developing world: Evaluating the iPhone mobile device as a screening tool

Peer

Fagan

2014

S Afr Med J

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Background. Developing countries have the world's highest prevalence of hearing loss, and hearing screening programmes are scarce. Mobile devices such as smartphones have potential for audiometric testing. Objectives. To evaluate the uHear app using an Apple iPhone as a possible hearing screening tool in the developing world, and to determine accuracy of certain hearing thresholds that could prove useful in early detection of hearing loss for high-risk populations in resource-poor communities.Methods. This was a quasi-experimental study design. Participants recruited from the Otolaryngology Clinic, Groote Schuur Hospital, Cape Town, South Africa, completed a uHear test in three settings -waiting room (WR), quiet room (QR) and soundproof room (SR). Thresholds were compared with formal audiograms. Results. Twenty-five patients were tested (50 ears). The uHear test detected moderate or worse hearing loss (pure-tone average (PTA) >40 dB) accurately with a sensitivity of 100% in all three environments. Specificity was 88% (SR), 73% (QR) and 68% (WR). It was highly accurate in detecting high-frequency hearing loss (2 000, 4 000, 6 000 Hz) in the QR and SR with 'good' and 'very good' kappa values, showing statistical significance (p<0.05). It was moderately accurate in low-frequency hearing loss (250, 500, 1 000 Hz) in the SR, and poor in the QR and WR. Conclusion. Using the iPhone, uHear is a feasible screening test to rule out significant hearing loss (PTA >40 dB). It is highly sensitive for detecting threshold changes at high frequencies, making it reasonably well suited to detect presbycusis and ototoxic hearing loss from HIV, tuberculosis therapy and chemotherapy. Portability and ease of use make it appropriate to use in developing world communities that lack screening programmes.

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Section: Chemotherapymentioning

confidence: 99%

mentioning

confidence: 99%

Hearing loss in the developing world: Evaluating the iPhone mobile device as a screening tool

Peer

Fagan

2014

S Afr Med J

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“…While a review of the available literature revealed that there is only one study reporting on the incidence rates for cisplatin-associated ototoxicity in South Africa [11], a pooled analysis of various international studies indicated an overall incidence of about 62% [6]. This phenomenon is further supported by numerous studies highlighting the ototoxic nature of cisplatin in exposed patients.…”

Section: Introductionmentioning

confidence: 99%

Research protocol: Cisplatin-associated ototoxicity amongst patients receiving cancer chemotherapy and the feasibility of an audiological monitoring program

2017

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BackgroundCisplatin is an anti-cancer chemotherapy drug classified as an alkylating agent. It is used for the treatment of a variety of cancers such as cervical, breast, stomach, prostate, bladder and oesophageal, to name a few. However due to its expansive toxicity profile, patients receiving cisplatin can experience high frequency hearing loss, a side effect known as ototoxicity. The dearth of information on the extent and severity of cisplatin-associated ototoxicity in South Africa prevents the implementation of a context-specific audiological monitoring programme.MethodsThis study aims to determine the extent and severity of ototoxicity amongst patients with cervical cancer, receiving cisplatin-based chemotherapy and hence the feasibility of an ototoxicity monitoring program in the province of KwaZulu-Natal, South Africa. A concurrent mixed methods design will be employed in the study. This longitudinal study will involve interviewing oncology nurses, oncologists, pharmacists and audiologists to assess the level of awareness to ototoxicity, as well as conducting diagnostic audiological evaluations at regular intervals on 78 patients with cervical cancer to ascertain the progression of hearing loss during and after chemotherapy. The feasibility of the monitoring program will be assessed as a parallel process to the audiological evaluations, where patient outcomes and cost implications to the patient and the health sector will be considered. Data will be subjected to statistical analyses so as to strengthen knowledge in the field and inform appropriate policies, and healthcare providers.DiscussionThis study is the first longitudinal study in South Africa to determine the ototoxic effects of cisplatin therapy on patients diagnosed with cervical cancer. Thus, the results generated from this study is likely to bring novel information to the fore using an evidence-based approach that will influence policy and clinical practice which can vastly improve the quality of life of patients undergoing chemotherapy. Mitigation of any further loss in the quality of life of affected patients is of paramount importance and the data generated from this project can lay the basis for further effective dialogue towards policy formulation on an ototoxic monitoring programme and the resultant strengthening of health systems in limited resource settings.Electronic supplementary materialThe online version of this article (10.1186/s12905-017-0486-8) contains supplementary material, which is available to authorized users.

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“…Cisplatin is one of the drugs which is best known to have this side effect [7,8] . To the best of our knowledge, trastuzumab and lapatinib have not been assessed for ototoxicity.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Lapatinib and Trastuzumab for Ototoxic Effects

Eryılmaz

Demirci²,

Günel³

et al. 2016

Int Adv Otol

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Original Article INTRODUCTIONTrastuzumab (Herceptin®; Genentech, California, San Francisco, USA) is used for treating human epidermal growth factor receptor 2 (HER2)-positive breast cancers. Trastuzumab is a humanized recombinant monoclonal antibody that acts on the extracellular portion of the HER2 protein [1] . Lapatinib (Tykerb®; Glaxo-Smith Kline) is a tyrosine kinase inhibitor that suppresses epidermal growth factor 1 (EGF-1) and intracellular phosphorylation of the HER-2/neu receptor. In studies with trastuzumab, cardiotoxicity is stated as the most common side effect [2] . The known side effects of lapatinib are the reduction of the left ventricular ejection fraction, interstitial lung disease/pneumonitis, dizziness, fatigue, severe diarrhea, dry cough, white sores in the mouth or lips, nosebleeds, nausea, stomach pain, jaundice, loss of appetite, aspartate aminotransferase (AST) changes, alanine aminotransferase (ALT) changes, and hematological changes [3,4] . To our knowledge, the ototoxicity of these chemotherapeutic agents has not yet been studied. The aim of this study is to identify whether these agents are ototoxic in rats and to determine the dose dependency of the ototoxicity. MATERIALS and METHODSThe study was approved by the Animal Experiments Ethical Committee of Adnan Menderes University (64583101/2013/038). A total of 48 male rats aged 4-8 months were randomly divided into six groups. All rats were subjected to distortion product otoacoustic emissions (DPOAE) on the first day after being anesthetized with ketamine/xylazine. Group 1 (control group) received Evaluation of Lapatinib and Trastuzumab for Ototoxic EffectsOBJECTIVE: Trastuzumab and lapatinib are widely used chemotherapeutic agents. Our aim in this study was to assess the possible ototoxicity of these chemotherapeutic agents. MATERIALS and METHODS:Forty-eight rats were divided into six groups: Group 1 (control, n=8) received intraperitoneal saline for 7 days. Group 2 (n=8) and Group 3 (n=8) received 10 mg/kg and 30 mg/kg single doses of intraperitoneal trastuzumab, respectively. Lapatinib was administered by oral gavage to Group 4 (n=8) at 100 mg/kg/day and to group 5 (n=8) at 300 mg/kg/day for 7 days. Group 6 (n=8) received only one dose of 10 mg/kg intraperitoneal trastuzumab; subsequently, Group 6 received one dose of lapatinib at 100 mg/kg/day by oral gavage for 7 days. Before any medication was administered, distortion product emissions (DPOAE) were obtained. DPOAE tests were performed again on the rats on day 7, after which the mastoid bullas were harvested. The apoptosis degree was evaluated by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) procedure. RESULTS:The lapatinib 300 and lapatinib+trastuzumab groups (p=0.008 and p=0.001, respectively) were significantly different from the control group according to the spiral ganglion TUNEL. Apoptosis in the organ of corti was statistically different compared with the control group in the lapatinib 100, lapatinib 300, and lapatinib+trastuzu...

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High prevalence of cisplatin-induced ototoxicity in Cape Town, South Africa

Cited by 31 publications

References 17 publications

Hearing loss in the developing world: Evaluating the iPhone mobile device as a screening tool

Hearing loss in the developing world: Evaluating the iPhone mobile device as a screening tool

Research protocol: Cisplatin-associated ototoxicity amongst patients receiving cancer chemotherapy and the feasibility of an audiological monitoring program

Evaluation of Lapatinib and Trastuzumab for Ototoxic Effects

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