Otoprotective Effects of Sodium Thiosulfate by Demographic and Clinical Characteristics: A Report From Children’s Oncology Group Study ACCL0431

Ohlsen TJD, Collier WH, Ramdas J, Sung L, Freyer DR. Otoprotective Effects of Sodium Thiosulfate by Demographic and Clinical Characteristics: A Report From Children’s Oncology Group Study ACCL0431. Pediatr Blood Cancer. 2025 Mar;72(3):e31479. doi: 10.1002/pbc.31479. Epub 2024 Dec 9. PMID: 39654065; PMCID: PMC11786791.

ACCL0431 was a randomized clinical trial that demonstrated efficacy of sodium thiosulfate (STS) for preventing cisplatin-induced hearing loss (CIHL) among patients 1–18 years old. The purpose of this study was to evaluate possible differential STS otoprotection among patient subgroups. This secondary analysis included ACCL0431 participants treated with cisplatin and randomized to receive STS or not (observation). Hearing status was obtained at 4 weeks and 12 months post cisplatin therapy (SIOP Ototoxicity Scale). Cumulative incidence of CIHL (Grade 1+) was assessed across age, sex, race/ethnicity, cancer diagnosis, and cisplatin infusion duration. Associations between these variables and CIHL were assessed using multivariable logistic regression. Interaction terms were used to evaluate potential heterogeneity in STS effect sizes across subgroups.