A new Cancer Research UK trial investigating whether high doses of aspirin can help prevent permanent hearing loss, a common side effect among cancer patients given the chemotherapy drug cisplatin.
Around 18,500 cancer patients of all ages receive cisplatin each year, around half of whom suffer some form of permanent hearing loss as a side effect of treatment, ranging from tinnitus (a high-pitched ringing in the ears) to some deafness in one or both ears.
The phase II trial, called COAST, is recruiting around 88 adult cancer patients who have been prescribed cisplatin at hospitals in Southampton, London, Glasgow, Birmingham, Leeds, Cardiff, Newcastle, Poole and Bournemouth.
Half of the patients will be given four daily doses of high-dose aspirin each time they receive the standard cisplatin treatment, starting a day before treatment and continuing for three days subsequently.
The remainder will be treated with a placebo for the same four days, with their cisplatin.
All patients will be given a hearing test just before starting their treatment and at one week and three months thereafter.
Cisplatin is a widely-used chemotherapy drug for treating testicular cancer, germ cell cancer, head and neck cancer, bladder cancer, cervical cancer, non small cell lung cancer and some types of children’s cancer.
Professor Emma King, chief investigator and Cancer Research UK surgeon at the University of Southampton, said: “Cisplatin is used to treat several different types of cancer and undoubtedly saves many thousands of lives every year. So it’s very unfortunate that for some patients this comes at the cost of some or all of their hearing. We don’t know exactly why this is, but it could be linked to the drug causing a build up of destructive molecules called ‘free radicals’. But aspirin seems to stop this happening by helping to mop them up before they can damage the delicate inner ear structures.
“Aspirin can have serious side effects, including internal bleeding, so it’s important to stress that aspirin is not suitable for all cancer patients. To help prevent these problems we’ll be giving patients specially coated aspirin tablets, that only release the drug once it reaches the small intestine, and also using another drug that reduces digestive juices, to prevent bleeding in the stomach.
“If this trial is successful, then a larger phase III trial will follow within two years that could potentially see aspirin become a routine part of cisplatin treatment for many thousands of cancer patients.”
Father-of-four Andrew Millington, 66, was given cisplatin as part of his treatment after a tumour was found at the base of his tongue.
He said: “I had a persistent sore throat and earache and went to see my GP last spring. I was referred to a consultant and had an MRI scan followed by a biopsy. It was naturally a shock to be told it was cancer but my doctor did say that it was generally curable, which was a great relief to hear. I was offered cisplatin and, after hearing about the possible side-effects, I was more than happy to take part in the COAST trial. I am all in favour of research and was happy to be part of the work to improve treatments.”
Kate Law, director of clinical research at Cancer Research UK, said: “We’re delighted to be funding this trial which, if successful, could in future help prevent treatment-related hearing loss among thousands of cancer patients.
“Thanks to work carried out by our scientists in the 1970s, cisplatin is now an extremely successful drug that has contributed to testicular cancer becoming a largely curable disease, and is a core part of treatment for a wide range of other cancers. This is good news, but we now need to find ways of refining treatment so patients can go on to enjoy long and full lives, without the burden of long term side effects.”