Which platinum agent is most associated with nephrotoxicity and ototoxicity?

• A. Cisplatin
• B. Carboplatin
• C. Oxaliplatin
• D. Dacarbazine

Answer: (A)

Cisplatin stands out for its kidney and ear toxicities. Platinum chemotherapy agents all cross-link DNA, but their side effects aren’t identical. Cisplatin tends to accumulate in renal tubular cells, causing proximal tubule injury that can impair kidney function and is a major dose-limiting toxicity. It also damages the cochlear hair cells in the inner ear, leading to ototoxicity with high-frequency hearing loss and tinnitus, which can be irreversible. Risk increases with higher cumulative doses, dehydration, preexisting kidney issues, and concurrent nephrotoxic drugs.

Other platinum drugs have different toxicity profiles. Carboplatin causes less nephrotoxicity and ototoxicity but more myelosuppression. Oxaliplatin is more associated with sensory neuropathy rather than kidney or ear toxicity. Dacarbazine isn’t a platinum agent and has its own distinct toxicity pattern. So, the agent most linked to both nephrotoxicity and ototoxicity is cisplatin.