Real-world feasibility and tolerability of Pedmark for otoprotection in young adults receiving cisplatin for solid tumors.

Abstract

e24189 Background: Cisplatin-induced ototoxicity is an irreversible toxicity that affects up to 90% of patients, with particularly profound consequences for young adults whose communication, education, and quality of life may be permanently impaired after treatment. As cancer survival improves, the need to preserve hearing and long-term function becomes critical. Pedmark (sodium thiosulfate) is the only FDA-approved agent for reducing the risk of cisplatin-induced hearing loss and is recommended for adolescents and young adults according to the NCCN guidelines. This study provides real-world data on its integration into adult oncology practice. Methods: This retrospective case series included nine patients aged 18–39 years with localized and disseminated solid tumors treated at a cancer center in 2024–2025. All patients received cisplatin-based chemotherapy with Pedmark administered six hours after cisplatin infusion. Supportive care included antiemetics (a combination of ondansetron, metoclopramide, olanzapine, and promethazine) and hydration. Outcomes assessed were feasibility of administration, Pedmark-related adverse events, and auditory symptoms. Results: All nine patients (testicular, cervical, germ cell, and head and neck cancers) received Pedmark without major complications or significant adverse events. Nausea was the most common adverse event (5/9 patients) and was effectively managed with antiemetics (ondansetron, metoclopramide, olanzapine, and promethazine) or infusion flow rate adjustments. One patient discontinued Pedmark at the recommendation of the clinical team following a self-limited episode of rigors. Importantly, no new-onset hearing loss or tinnitus was reported. There were no Cisplatin dose reductions, treatment delays, or other deviations from planned therapy. All patients completed their intended cancer treatment courses, demonstrating that Pedmark can be successfully integrated into routine Cisplatin regimens to reduce ototoxicity and improve survivorship outcomes. Conclusions: Preventing ototoxicity is critical for preserving long-term quality of life in young adults treated with Cisplatin. This real-world case series demonstrates that Pedmark can be feasibly incorporated into adult oncology workflows and does not interfere with Cisplatin-based treatment. These findings support the routine adoption of Pedmark for young adults to reduce the risk of Cisplatin-induced hearing loss and enhance survivorship outcomes.