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Immune checkpoint inhibitor-related hearing loss: a systematic review and analysis of individual patient data

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Abstract

Purpose

Immune checkpoint inhibitors (ICIs) are related to various immune-related adverse events (irAEs). However, the knowledge is limited with rare irAEs like hearing loss. Therefore, we evaluated the characteristics, presentation, and treatment of ICI-related hearing loss by reviewing the individual patient data from the previous studies.

Methods

We conducted a systematic search of the Web of Science, PubMed, and Embase databases for studies published until 17 November 2022. The selected MeSH search terms were “hearing loss” OR “hearing impairment” OR “ototoxicity” OR “vestibular toxicity” OR “audiovestibular toxicity” AND “immune checkpoint inhibitor” OR “immunotherapy.”

Results

A total of 38 patients were included. Melanoma was the most frequent diagnosis (73.7%). The median time from ICI initiation to hearing loss development was 3 months. The hearing impairment was secondary to bilateral sensorineural hearing loss (SNHL) in 24 (68.6%) patients, and at least one other irAE accompanied the hearing loss in 24 patients. Hearing loss significantly improved in 45.7% of the patients. The overall response rate and disease control rate were 67.6% and 85.3%, respectively.

Conclusion

We observed that most cases of ICI-related hearing loss were reversible, observed in patients with melanoma, accompanied by other irAEs, and associated with a high response rate to ICIs. With the expanded use of ICIs in the earlier treatment lines and adjuvant settings, the number of survivors with ICI-related hearing loss is expected to increase. Further research is needed to define the true prevalence of ICI-related hearing loss, optimal diagnosis, and management.

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Data availability

The study data is available upon reasonable request to the authors.

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Author information

Authors and Affiliations

  1. Medical Oncology Clinic, Health Sciences University, Elazig City Hospital, Ulukent, 23280, Elazig, Turkey

    Deniz Can Guven

  2. Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Enes Erul & Yunus Kaygusuz

  3. Department of Medical Oncology, Erzincan Binali Yıldırım University Medical School, Erzincan, Turkey

    Baran Akagunduz

  4. Department of Medical Oncology, Faculty of Medicine, Istinye University, Istanbul, Turkey

    Saadettin Kilickap

  5. Department of Surgical Oncology, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124, Bari, Italy

    Raffaele De Luca

  6. Struttura Semplice Dipartimentale Di Oncologia Medica Per La Presa in Carico Globale del Paziente Oncologico “Don Tonino Bello,” I.R.C.C.S. Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124, Bari, Italy

    Alessandro Rizzo

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Contributions

The work reported in the paper has been performed by the authors, unless clearly specified in the text. CRediT author statement is listed below.

Deniz Can Guven: Conceptualization, Data Curation, Methodology, Writing Original Draft, Visualization.

Enes Erul: Investigation, Data Curation, Methodology, Writing-Review&Editing.

Yunus Kaygusuz: Investigation, Visualization, Data Curation, Methodology.

Baran Akagunduz: Investigation, Visualization, Methodology.

Saadettin Kilickap: Investigation, Visualization, Methodology.

Raffaele Luca: Investigation, Data Curation, Methodology, Writing Original Draft.

Alessandro Rizzo: Conceptualization, Writing-Review&Editing, Supervision, Project Administration.

Corresponding author

Correspondence to Deniz Can Guven.

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Guven, D.C., Erul, E., Kaygusuz, Y. et al. Immune checkpoint inhibitor-related hearing loss: a systematic review and analysis of individual patient data. Support Care Cancer 31, 624 (2023). https://doi.org/10.1007/s00520-023-08083-w

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