A new study by researchers at University College London (UCL) has shown that hearing loss caused by the chemotherapy drug cisplatin can be detected outside of an audiology clinic. This paves the way for more accessible monitoring for people undergoing cancer treatment.
How cisplatin can cause hearing loss
Cisplatin is a highly effective anti‑cancer drug, but it can cause damage to the inner ear. This is known as ototoxicity and can lead to permanent hearing loss.
Up to 60% of young patients receiving cisplatin experience hearing loss or tinnitus during or after treatment.
However, monitoring for ototoxicity during chemotherapy is difficult. People often feel too unwell from treatment to travel to audiology clinics, so they may miss important hearing checks.
Part of this research, led by the UCLH BRC Hearing Health Theme, was supported by an RNID Innovation Seed Fund grant. The research team tested whether hearing changes could be monitored in teenagers and young adults who were undergoing cancer treatment when they attended cancer walk-in support services.
Key findings of the research
The team used a combination of methods to monitor hearing and possible damage to the inner ear outside of an audiology booth:
- Tablet‑based audiometry: participants completed self‑administered hearing assessments in a quiet room during their cancer clinic visits.
- Distortion Product Otoacoustic Emissions: a quick test that is similar to the one used in newborn hearing screening.
- Blood tests for prestin‑1: a protein found in outer hair cells in the inner ear. High levels in the blood may be a sign of early damage.
The researchers found that:
- It was possible to monitor hearing in this setting, and patients were happy for their hearing to be tested during cancer clinic visits
- Levels of prestin-1 tended to be higher in in the blood of patients who showed early signs of hearing changes, supporting further research into its potential as a blood biomarker for ototoxicity
RNID’s funding contributed to establishing the equipment and laboratory methods needed for this approach, enabling the team to collect valuable early data.
Why this discovery matters
Ototoxicity is a devastating side effect of chemotherapy, but now biotechnology companies are developing the first generation of otoprotective drugs – medicines designed to protect the inner ear during chemotherapy.
To test these new treatments in clinical trials, researchers need easy and reliable ways to check hearing regularly during chemotherapy.
This study shows that:
- hearing can be monitored outside an audiology clinic
- there may be blood biomarkers (like prestin-1) to detect cochlear damage early
Roulla Katiri, Clinical Research Audiologist at UCL, a key author of the study, said:
By bringing audiology, ENT, and medical oncology expertise together, we can enable much earlier detection of ototoxicity. Multi-disciplinary collaboration can streamline diagnostic pathways thus making monitoring more accessible and achievable for patients during their chemotherapy cancer treatment.
With novel otoprotective drug treatments on the way, there is a growing need for simple, real‑time ways to monitor hearing in people receiving chemotherapy. More work is needed to roll this out efficiently across multiple oncology clinics.”
What happens next?
The researchers’ next steps include:
- Confirming whether prestin‑1 is a reliable marker of inner ear damage caused by cisplatin.
- Conducting studies with a control group of patients receiving chemotherapy without cisplatin, to confirm whether changes in prestin are caused specifically by cisplatin exposure.
- Testing whether this out‑of‑booth monitoring approach can be scaled across different NHS oncology clinics.
- Exploring how this model could support future clinical trials of emerging otoprotective drugs.
These steps will be essential before the approach can be routinely adopted or used to support new treatment pathways.
Making hearing checks easier and more accessible could help spot ototoxicity earlier and give people the support and treatment they need sooner.
Publication details
This research was published in February in the journal Otology and Neurotology.
