Cisplatin is widely used to treat cancers. It is the most ototoxic
drug in clinical use, resulting in permanent hearing loss in approximately 50%
of treated patients. There is a major need for therapies that prevent
cisplatin-induced hearing loss. Studies in mice suggest that concurrent use of
statins reduces cisplatin-induced hearing loss.
Fernandez and her colleagues (from the National Institute on
Deafness and Other Communication Disorders, and Johns Hopkins University,
Maryland ; University of Rochester Medical Center, New York; and Medical
University of South Carolina, Charleston, South Carolina; USA) retrospectively examined
hearing thresholds from 277 adults treated with cisplatin for head and neck
cancer. The results were published in Clinical Trial Journal of Clinical Investigation in 2021.
Pretreatment and posttreatment audiograms were collected
within 90 days of initiation and completion of cisplatin therapy. The primary
outcome measure was a change in hearing as defined by the National Cancer
Institute Common Terminology Criteria for Adverse Events (CTCAE).
Among patients on concurrent atorvastatin, 9.7% experienced
a CTCAE grade 2 or higher cisplatin-induced hearing loss compared with 29.4% in
nonstatin users (P < 0.0001).
Analysis showed that
atorvastatin use was significantly associated with reduced cisplatin-induced
hearing loss (P ≤ 0.01). An adjusted odds ratio (OR) analysis indicated that an
atorvastatin user is 53% less likely to acquire a cisplatin-induced hearing
loss than a nonstatin user (OR = 0.47; 95% CI, 0.30-0.78). Three-year survival
rates were not different between atorvastatin users and nonstatin users (P >
0.05).
The data indicate that atorvastatin use is associated with
reduced incidence and severity of cisplatin-induced hearing loss in adults
being treated for head and neck cancer. A prospective study is currently conducted to evaluate the efficacy of statins in preventing hearing loss by
cisplatin.
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