NAC to Prevent Cisplatin-induced Hearing Loss

Inclusion Criteria

• •Are between 1 and 21 years of age (inclusive) at time of diagnosis of underlying malignancy
• •Have a new diagnosis of a localized malignancy with a planned treatment course to include at least two cycles of cisplatin
• •Diagnosis to be assigned by oncology attending of record (may be reported via designee), histological diagnosis does not need to be confirmed separately
• •Most common but not exclusive diagnoses consist of hepatoblastoma, medulloblastoma, osteosarcoma
• •Total cumulative dose of planned cisplatin must be \>200 mg/m2 (or 6.67 mg/kg equivalent for infants requiring weight-based dosing. Conversion factor used is 30:1).
• •Cisplatin must be delivered over \<3 days
• •Planned cisplatin dose to be infused over ≤6 hours for ≤2 days per cycle
• •Are anticipated to be able to comply with end-of-therapy audiology assessment (note that hearing assessments are performed per routine clinical care in children receiving cisplatin and consist of an audiogram or auditory brainstem response, and distortion-product otoacoustic emissions)
• •Patients with any hearing status are eligible for study (as long as they can comply with the study primary aims of assessing toxicity and dose-response)