Review: Ototoxic Characteristics of Platinum Antitumor Drugs
Article first published online: 8 OCT 2012
Copyright © 2012 Wiley Periodicals, Inc.
The Anatomical Record
Special Issue: The Anatomy and Biology of Hearing and Balance: Cochlear and Vestibular Implants
Volume 295, Issue 11, pages 1851–1867, November 2012
How to Cite
Ding, D., Allman, B. L. and Salvi, R. (2012), Review: Ototoxic Characteristics of Platinum Antitumor Drugs. Anat Rec, 295: 1851–1867. doi: 10.1002/ar.22577
- Issue published online: 22 OCT 2012
- Article first published online: 8 OCT 2012
- Manuscript Received: 24 JUL 2012
- Manuscript Accepted: 24 JUL 2012
- NIH. Grant Numbers: R01DC009091, R01DC009219
- ethacrynic acid;
- copper transporter
Cisplatin, carboplatin, nedaplatin, and oxaliplatin are widely used in contemporary oncology; however, their ototoxic and neurotoxic side effects are quite different as discussed in this review. Cisplatin is considered the most ototoxic, but despite its reputation, the magnitude of hair cell loss that occurs with a single, large drug bolus is limited and confined to the base of the cochlea. For all of these platinum compounds, a major factor limiting damage is drug uptake from stria vascularis into the cochlear fluids. Disrupting the blood–labyrinth barrier with diuretics or noise exposure enhances drug uptake and significantly increases the amount of damage. Combined treatment with ethacrynic acid (a loop diuretic) and cisplatin results in rapid apoptotic hair cell death characterized by upregulation of initiator caspase-8 and membrane death receptor, TRADD, followed by downstream executioners, caspase-3 and caspase-6. Unlike cisplatin, nedaplatin and oxaliplatin are highly neurotoxic when applied to cochlear cultures preferentially damaging auditory nerve fibers at low concentrations and hair cells at high concentrations. Carboplatin, considered far less ototoxic than cisplatin, is paradoxically highly toxic to chinchilla inner hair cells and type I spiral ganglion neurons; however, at high doses it also damages outer hair cells. Hair cell death from cisplatin and carboplatin is characterized in its early stages by upregulation of p53; blocking p53 expression with pifithrin-α prevents hair cell death. Major differences in the toxicity of these four platinum compounds may arise from several different metal transporters that selectively regulate the influx, efflux, and sequestration of these drugs. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc.