Meta-analysis links vincristine and other drugs to higher cisplatin hearing loss risk in pediatric cancer

Cisplatin induced hearing loss (CIHL) affects 50-70% of all cisplatin-treated children. Cisplatin containing regimens often include various supportive care drugs and chemotherapeutic agents. No structured overview is available of the potential impact of concomitant medication, administered alongside cisplatin, on the increased risk of CIHL. A narrative review, based on a PubMed (Medline), EMBASE, and Cochrane CENTRAL search, was conducted to summarize the effect of concomitant chemotherapeutic agents and supportive care drugs on developing hearing loss in cisplatin-treated pediatric cancer patients. The studies were categorized according to type of comedication. Our review identified 27 relevant studies with a total of 7007 patients. There is heterogeneity among the included studies with respect to design and quality. Nevertheless, the results of the meta-analyses showed that vincristine (OR: 3.80, 95% CI: 2.86-5.04), furosemide (OR: 1.63, 95% CI: 1.14-2.33), aminoglycosides (OR: 1.72, 95% CI: 1.14-2.60) and vancomycin (OR: 1.63, 95% CI: 1.09-2.45) were recurrently found to be associated with an increased risk of CIHL. This review represents the first comprehensive overview of evidence on the contribution of comedication to the risk of CIHL. Vincristine, furosemide, ahminoglycosides, and vancomycin are associated with an increased risk of CIHL in pediatric cancer patients.