Sodium Thiosulfate and the Prevention of Hearing Loss in Cisplatin-treated Patients

David Freyer, DO
Published Online: May 1, 2017

Sodium thiosulfate (STS) is a water-soluble thiol compound and acts as a chemical reducing agent.  Administration of STS may protect against platinum-induced ototoxicity.
David Freyer, DO, of the Children's Hospital of Los Angeles explains the clinical trial he was involved with showing that the administration of STS in pediatric cancer patients receiving cisplatin reduced the number of patients developing hearing loss. 
Hearing loss is a common side effect in children (and adults) treated with cisplatin, a standard chemotherapy agent used in oncology. 
As Dr Freyer explains in this video, the trial, referred to as ACCL0431, was a  multicenter, randomized, open-label, phase 3 trial in which pediatric cancer patients being given cisplatin were randomized to also receive STS (n=61) or observation (n=64).
Hearing loss was identified in 28.6% participants in the STS group compared with 56% in the control group (P = .00022). 
This trial also observed a slight decrease in overall survival in the STS plus cisplatin group. This result was unexpected and from a biological perspective, unexplainable. Since it was a secondary outcome measure, another study is currently underway in Europe that will hopefully provide more clarity to this latter observation. 


Freyer DR, Chen L, Krailo MD, et al. Effects of sodium thiosulfate versus observation on development of cisplatin-induced hearing loss in children with cancer (ACCL0431): a multicentre, randomised, controlled, open-label, phase 3 trial. Lancet Oncol. 2017;18:63-74. doi: 10.1016/S1470-2045(16)30625-8

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