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COAST (Cisplatin ototoxicity attenuated by aspirin trial): A phase II double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss
BACKGROUND: Cisplatin is one of the most ototoxic chemotherapy drugs, resulting in a permanent and irreversible hearing loss in up to 50% of patients. Cisplatin and gentamicin are thought to damage hearing through a common mechanism, involving reactive oxygen species in the inner ear. Aspirin has be...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Science Ltd
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729023/ https://www.ncbi.nlm.nih.gov/pubmed/29128692 http://dx.doi.org/10.1016/j.ejca.2017.09.033 |
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author | Crabb, Simon J. Martin, Karen Abab, Julia Ratcliffe, Ian Thornton, Roger Lineton, Ben Ellis, Mary Moody, Ronald Stanton, Louise Galanopoulou, Angeliki Maishman, Tom Geldart, Thomas Bayne, Mike Davies, Joe Lamb, Carolynn Popat, Sanjay Joffe, Johnathan K. Nutting, Chris Chester, John Hartley, Andrew Thomas, Gareth Ottensmeier, Christian Huddart, Robert King, Emma |
author_facet | Crabb, Simon J. Martin, Karen Abab, Julia Ratcliffe, Ian Thornton, Roger Lineton, Ben Ellis, Mary Moody, Ronald Stanton, Louise Galanopoulou, Angeliki Maishman, Tom Geldart, Thomas Bayne, Mike Davies, Joe Lamb, Carolynn Popat, Sanjay Joffe, Johnathan K. Nutting, Chris Chester, John Hartley, Andrew Thomas, Gareth Ottensmeier, Christian Huddart, Robert King, Emma |
author_sort | Crabb, Simon J. |
collection | PubMed |
description | BACKGROUND: Cisplatin is one of the most ototoxic chemotherapy drugs, resulting in a permanent and irreversible hearing loss in up to 50% of patients. Cisplatin and gentamicin are thought to damage hearing through a common mechanism, involving reactive oxygen species in the inner ear. Aspirin has been shown to minimise gentamicin-induced ototoxicity. We, therefore, tested the hypothesis that aspirin could also reduce ototoxicity from cisplatin-based chemotherapy. METHODS: A total of 94 patients receiving cisplatin-based chemotherapy for multiple cancer types were recruited into a phase II, double-blind, placebo-controlled trial and randomised in a ratio of 1:1 to receive aspirin 975 mg tid and omeprazole 20 mg od, or matched placebos from the day before, to 2 days after, their cisplatin dose(s), for each treatment cycle. Patients underwent pure tone audiometry before and at 7 and 90 days after their final cisplatin dose. The primary end-point was combined hearing loss (cHL), the summed hearing loss at 6 kHz and 8 kHz, in both ears. RESULTS: Although aspirin was well tolerated, it did not protect hearing in patients receiving cisplatin (p-value = 0.233, 20% one-sided level of significance). In the aspirin arm, patients demonstrated mean cHL of 49 dB (standard deviation [SD] 61.41) following cisplatin compared with placebo patients who demonstrated mean cHL of 36 dB (SD 50.85). Women had greater average hearing loss than men, and patients treated for head and neck malignancy experienced the greatest cHL. CONCLUSIONS: Aspirin did not protect from cisplatin-related ototoxicity. Cisplatin and gentamicin may therefore have distinct ototoxic mechanisms, or cisplatin-induced ototoxicity may be refractory to the aspirin regimen used here. |
format | Online Article Text |
id | pubmed-5729023 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier Science Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-57290232017-12-22 COAST (Cisplatin ototoxicity attenuated by aspirin trial): A phase II double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss Crabb, Simon J. Martin, Karen Abab, Julia Ratcliffe, Ian Thornton, Roger Lineton, Ben Ellis, Mary Moody, Ronald Stanton, Louise Galanopoulou, Angeliki Maishman, Tom Geldart, Thomas Bayne, Mike Davies, Joe Lamb, Carolynn Popat, Sanjay Joffe, Johnathan K. Nutting, Chris Chester, John Hartley, Andrew Thomas, Gareth Ottensmeier, Christian Huddart, Robert King, Emma Eur J Cancer Article BACKGROUND: Cisplatin is one of the most ototoxic chemotherapy drugs, resulting in a permanent and irreversible hearing loss in up to 50% of patients. Cisplatin and gentamicin are thought to damage hearing through a common mechanism, involving reactive oxygen species in the inner ear. Aspirin has been shown to minimise gentamicin-induced ototoxicity. We, therefore, tested the hypothesis that aspirin could also reduce ototoxicity from cisplatin-based chemotherapy. METHODS: A total of 94 patients receiving cisplatin-based chemotherapy for multiple cancer types were recruited into a phase II, double-blind, placebo-controlled trial and randomised in a ratio of 1:1 to receive aspirin 975 mg tid and omeprazole 20 mg od, or matched placebos from the day before, to 2 days after, their cisplatin dose(s), for each treatment cycle. Patients underwent pure tone audiometry before and at 7 and 90 days after their final cisplatin dose. The primary end-point was combined hearing loss (cHL), the summed hearing loss at 6 kHz and 8 kHz, in both ears. RESULTS: Although aspirin was well tolerated, it did not protect hearing in patients receiving cisplatin (p-value = 0.233, 20% one-sided level of significance). In the aspirin arm, patients demonstrated mean cHL of 49 dB (standard deviation [SD] 61.41) following cisplatin compared with placebo patients who demonstrated mean cHL of 36 dB (SD 50.85). Women had greater average hearing loss than men, and patients treated for head and neck malignancy experienced the greatest cHL. CONCLUSIONS: Aspirin did not protect from cisplatin-related ototoxicity. Cisplatin and gentamicin may therefore have distinct ototoxic mechanisms, or cisplatin-induced ototoxicity may be refractory to the aspirin regimen used here. Elsevier Science Ltd 2017-12 /pmc/articles/PMC5729023/ /pubmed/29128692 http://dx.doi.org/10.1016/j.ejca.2017.09.033 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Crabb, Simon J. Martin, Karen Abab, Julia Ratcliffe, Ian Thornton, Roger Lineton, Ben Ellis, Mary Moody, Ronald Stanton, Louise Galanopoulou, Angeliki Maishman, Tom Geldart, Thomas Bayne, Mike Davies, Joe Lamb, Carolynn Popat, Sanjay Joffe, Johnathan K. Nutting, Chris Chester, John Hartley, Andrew Thomas, Gareth Ottensmeier, Christian Huddart, Robert King, Emma COAST (Cisplatin ototoxicity attenuated by aspirin trial): A phase II double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss |
title | COAST (Cisplatin ototoxicity attenuated by aspirin trial): A phase II double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss |
title_full | COAST (Cisplatin ototoxicity attenuated by aspirin trial): A phase II double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss |
title_fullStr | COAST (Cisplatin ototoxicity attenuated by aspirin trial): A phase II double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss |
title_full_unstemmed | COAST (Cisplatin ototoxicity attenuated by aspirin trial): A phase II double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss |
title_short | COAST (Cisplatin ototoxicity attenuated by aspirin trial): A phase II double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss |
title_sort | coast (cisplatin ototoxicity attenuated by aspirin trial): a phase ii double-blind, randomised controlled trial to establish if aspirin reduces cisplatin induced hearing-loss |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729023/ https://www.ncbi.nlm.nih.gov/pubmed/29128692 http://dx.doi.org/10.1016/j.ejca.2017.09.033 |
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