Avoiding Cisplatin-Related Hearing Loss, Including Implementing Sodium Thiosulfate as Otoprotectant Into Daily Pediatric Clinical Practice: Proceedings Based on Evidence and Expert Opinion From the Ototoxicity Taskforce of the SIOP Supportive Care Network
Abstract
OBJECTIVES: Sodium thiosulfate (STS) has recently been approved as an otoprotectant for systemic use in pediatric cancer patients receiving cisplatin treatment for localized, nonmetastatic solid tumors by the Food and Drug Administration, European Medicines Agency, and Medicines and Healthcare Products Regulatory Agency. While incorporating STS into the current standard of care pediatric practice, questions about uniform, timely, and safe administration are raised that may benefit from additional guidance. DESIGN: Recognizing that advancing clinical practice presents multiple challenges, an international onco-ototoxicity prevention task force, including experts in pediatric oncology, audiology, and pharmacology, was established to identify potential barriers to the implementation of otoprotection and to offer practical solutions for clinical services for children exposed to cisplatin, based on available evidence, as well as consensus where data are less robust. This task force held several online meetings and a working group session at the annual SIOPE meeting in Milan in May 2024, where the challenges for implementing STS were outlined and addressed. RESULTS: Nine key challenges were identified, including, for example, the timing of both cisplatin infusion and STS administration, the optimal integration of STS into existing treatment protocols, potential drug interactions, and relevant economic considerations. CONCLUSION: In this article, we propose practical steps to address these challenges, informed by the existing literature and expert opinion, incorporating recommendation statements from the international onco-ototoxicity prevention task force on behalf of the SIOP Supportive Care Network, to facilitate the implementation of STS in children with localized, nonmetastatic disease.
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BibTeX
@article{streefkerk2026avoiding,
title = {{Avoiding Cisplatin-Related Hearing Loss, Including Implementing Sodium Thiosulfate as Otoprotectant Into Daily Pediatric Clinical Practice: Proceedings Based on Evidence and Expert Opinion From the Ototoxicity Taskforce of the SIOP Supportive Care Network}},
author = {Nienke Streefkerk and James I. Geller and Kristin Knight and Marc Ansari and Vassilios Papadakis and Gabriele Calaminus and Amirhossein Masroor and Alwin D.R. Huitema and Claudia Pasqualini and Stefan Rutkowski and Eric Bouffet and Antoinette Am Zehnhoff-Dinnesen and Miguela Caniza and Marianne D. van de Wetering and Pia Delano and Kaukab M. Rajput and Heather Weerdenburg and A. Lindsay Frazier and Alexander E. Hoetink and Martine van Grotel and Nathalie Gaspar and Furqan Shaikh and Brice Fresneau and Allison F. O'Neill and Gareth J. Veal and Michael Sullivan and Penelope R. Brock and Marry M. van den Heuvel-Eibrink},
journal = {Ear \& Hearing},
year = {2026},
month = jun,
doi = {10.1097/aud.0000000000001856},
url = {https://hal.science/hal-05845226v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Avoiding Cisplatin-Related Hearing Loss, Including Implementing Sodium Thiosulfate as Otoprotectant Into Daily Pediatric Clinical Practice: Proceedings Based on Evidence and Expert Opinion From the Ototoxicity Taskforce of the SIOP Supportive Care Network
AU - Nienke Streefkerk
AU - James I. Geller
AU - Kristin Knight
AU - Marc Ansari
AU - Vassilios Papadakis
AU - Gabriele Calaminus
AU - Amirhossein Masroor
AU - Alwin D.R. Huitema
AU - Claudia Pasqualini
AU - Stefan Rutkowski
AU - Eric Bouffet
AU - Antoinette Am Zehnhoff-Dinnesen
AU - Miguela Caniza
AU - Marianne D. van de Wetering
AU - Pia Delano
AU - Kaukab M. Rajput
AU - Heather Weerdenburg
AU - A. Lindsay Frazier
AU - Alexander E. Hoetink
AU - Martine van Grotel
AU - Nathalie Gaspar
AU - Furqan Shaikh
AU - Brice Fresneau
AU - Allison F. O'Neill
AU - Gareth J. Veal
AU - Michael Sullivan
AU - Penelope R. Brock
AU - Marry M. van den Heuvel-Eibrink
PY - 2026
DA - 2026/06/26
JO - Ear & Hearing
DO - 10.1097/aud.0000000000001856
UR - https://hal.science/hal-05845226v1
AB - OBJECTIVES: Sodium thiosulfate (STS) has recently been approved as an otoprotectant for systemic use in pediatric cancer patients receiving cisplatin treatment for localized, nonmetastatic solid tumors by the Food and Drug Administration, European Medicines Agency, and Medicines and Healthcare Products Regulatory Agency. While incorporating STS into the current standard of care pediatric practice, questions about uniform, timely, and safe administration are raised that may benefit from additional guidance. DESIGN: Recognizing that advancing clinical practice presents multiple challenges, an international onco-ototoxicity prevention task force, including experts in pediatric oncology, audiology, and pharmacology, was established to identify potential barriers to the implementation of otoprotection and to offer practical solutions for clinical services for children exposed to cisplatin, based on available evidence, as well as consensus where data are less robust. This task force held several online meetings and a working group session at the annual SIOPE meeting in Milan in May 2024, where the challenges for implementing STS were outlined and addressed. RESULTS: Nine key challenges were identified, including, for example, the timing of both cisplatin infusion and STS administration, the optimal integration of STS into existing treatment protocols, potential drug interactions, and relevant economic considerations. CONCLUSION: In this article, we propose practical steps to address these challenges, informed by the existing literature and expert opinion, incorporating recommendation statements from the international onco-ototoxicity prevention task force on behalf of the SIOP Supportive Care Network, to facilitate the implementation of STS in children with localized, nonmetastatic disease.
SN - 1538-4667
SN - 0196-0202
ER -