Arya Priya, Salmerón Yansy, Quimby Alexandra E, Wong Kevin, Brant Jason A, Hwa Tiffany P
Department of Otolaryngology-Head and Neck Surgery, Mercer University School of Medicine, Savannah, Georgia, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, U.S.A.
Laryngoscope. 2025 Feb;135(2):491-506. doi: 10.1002/lary.31763. Epub 2024 Sep 13.
To ascertain trends in ototoxicity observed with monoclonal antibodies (mABs) and understand the impact they may have on hearing function.
PubMed, Embase, Scopus.
A systematic review was performed following PRISMA guidelines. Data were reviewed for demographics, utilized mABs with respective indication and dosing, audiometric outcomes, and treatment for otologic effects.
Of 757 studies reviewed, a total of 44 were included, encompassing 18,046 patients treated with mABs. Mean age of the sample was 57.8 years old. The search yielded 18 agents of ototoxicity, with reported symptoms of ototoxicity such as hearing loss, tinnitus, and/or aural fullness occurring in 1079 of total patients. Main agents causing ototoxicity were teprotumumab (n = 17/44 studies), nivolumab (n = 10/44), ipilimumab (n = 9/44), pembrolizumab (n = 5/44), and rituximab (n = 4/44). Thirty-one of 44 studies encompassing eight agents reported audiometric data for ototoxic agents, showing sensorineural hearing loss primarily in the high-frequency range. Only two articles performed ultrahigh-frequency audiograms.
Monoclonal antibody usage is expanding, but the vast majority of studies lack substantial audiometric data. Where reported, study design and inclusion criteria vary greatly. Future studies would benefit from rigid inclusion of audiometric data, prospective study design, and consideration of formal ototoxicity screening. Otolaryngologists should be aware of the cochlear immune response and potential impact of this expanding medication class on hearing function. Laryngoscope, 135:491-506, 2025.
确定单克隆抗体（mABs）引起耳毒性的趋势，并了解其对听力功能可能产生的影响。
PubMed、Embase、Scopus。
按照PRISMA指南进行系统综述。对人口统计学数据、使用的单克隆抗体及其各自的适应证和剂量、听力测量结果以及耳部效应的治疗进行了综述。
在757项综述研究中，共纳入44项，涉及18046例接受单克隆抗体治疗的患者。样本的平均年龄为57.8岁。检索到18种具有耳毒性的药物，1079例患者出现了如听力损失、耳鸣和/或耳闷等耳毒性症状。导致耳毒性的主要药物为替普罗单抗（n = 17/44项研究）、纳武单抗（n = 10/44）、伊匹单抗（n = 9/44）、帕博利珠单抗（n = 5/44）和利妥昔单抗（n = 4/44）。44项研究中的31项涉及8种药物，报告了耳毒性药物的听力测量数据，主要显示高频范围的感音神经性听力损失。只有两篇文章进行了超高频听力图检查。
单克隆抗体的使用正在扩大，但绝大多数研究缺乏大量的听力测量数据。在有报告的情况下，研究设计和纳入标准差异很大。未来的研究将受益于严格纳入听力测量数据、前瞻性研究设计以及考虑正式的耳毒性筛查。耳鼻喉科医生应了解耳蜗免疫反应以及这一不断扩大的药物类别对听力功能的潜在影响。《喉镜》，135:491 - 506，2025年。
