Pedmark (sodium thiosulfate) / Fennec Pharma, Norgine - LARVOL DELTA

Randomized phase 1 trial of cisplatin-based chemotherapy with or without sodium thiosulfate for men with metastatic germ cell tumor (GCT). (ASCO 2026) - P1 | "Sodium thiosulfate (STS; PEDMARK) was FDA-approved in 2022 to reduce the risk of cisplatin-associated ototoxicity in pediatric patients 1 month of age and older with localized, non-metastatic solid tumors. Enrollment has begun. Clinical trial registry: NCT07218913"

Clinical • Metastases • P1 data • Germ Cell Tumors • Immunology • Oncology • Otorhinolaryngology

REAL WORLD MONITORING OF OTOTOXICITY AND CLINICAL UTILITY OF SODIUM THIOSULFATE INJECTION IN AYA AND ADULT CANCER PATIENTS RECEIVING CISPLATIN (MASCC-ISOO 2026) - "The study evaluates the incidence and severity of ototoxicity alongside the clinical utility of sodium thiosulfate injection (PEDMARK) in adolescent and young adult (AYA) and adult cancer patients receiving cisplatin chemotherapy. These findings further support the need to evaluate preventive strategies, such as sodium thiosulfate injection, to mitigate treatment-induced ototoxicity. This study will provide foundational evidence that is critical to enhance clinical standards for assessing and preventing ototoxicity in real-world settings."

Clinical • Real-world • Real-world evidence • Bladder Cancer • Gastrointestinal Cancer • Oncology • Otorhinolaryngology • Solid Tumor

Real-world feasibility and tolerability of Pedmark for otoprotection in young adults receiving cisplatin for solid tumors. (ASCO 2026) - "Supportive care included antiemetics (a combination of ondansetron, metoclopramide, olanzapine, and promethazine) and hydration. Preventing ototoxicity is critical for preserving long-term quality of life in young adults treated with Cisplatin. This real-world case series demonstrates that Pedmark can be feasibly incorporated into adult oncology workflows and does not interfere with Cisplatin-based treatment. These findings support the routine adoption of Pedmark for young adults to reduce the risk of Cisplatin-induced hearing loss and enhance survivorship outcomes."

Clinical • Real-world • Real-world evidence • Head and Neck Cancer • Oncology • Otorhinolaryngology • Solid Tumor

Audiometric outcomes for intravenous sodium thiosulfate for cisplatin-induced ototoxicity prevention in adults with head and neck cancer. (ASCO 2026) - "While sodium thiosulfate (STS; Pedmark) has demonstrated reduced rates of CIO in the pediatric population, there remains a critical evidence gap regarding its efficacy in adult pts with head and neck cancer (HNC). Delayed IV STS was associated with preservation of clinically significant hearing in adults with HNC receiving curative-intent cisplatin, despite measurable changes on extended high-frequency audiometry and DPOAE testing. These findings support the use of comprehensive audiometric monitoring, including extended ehfPTA and DPOAE, to detect subclinical ototoxicity. The results extend the otoprotective paradigm established in pediatric oncology to the adult setting and suggest that STS is a feasible otoprotective strategy during platinum-based therapy."

Clinical • Head and Neck Cancer • Oncology • Otorhinolaryngology • Solid Tumor

Effects of delayed sodium thiosulfate on cisplatin-induced ototoxicity in pediatric and adolescent patients with cancer: Results from the Japanese Children's Cancer Group STS-J01 study. (ASCO 2026) - "Delayed administration of sodium thiosulfate (PEDMARK) has demonstrated otoprotection in Western trials. Delayed administration of sodium thiosulfate significantly reduced cisplatin-induced ototoxicity without compromising antitumor efficacy in Japanese pediatric and adolescent patients, confirming reproducibility of sodium thiosulfate otoprotection across populations. Summary of STS-J01 trial. *One case was unevaluated for treatment response."

Clinical • Oncology • Otorhinolaryngology • Pediatrics • Solid Tumor

Ph. I/II Sodium Thiosulfate for OtoProtection During Cisplatin (STOP-CIS) (clinicaltrials.gov) - P1/2 | N=25 | Recruiting | Sponsor: University of Arizona | Not yet recruiting ➔ Recruiting

Enrollment open • Genito-urinary Cancer • Head and Neck Cancer • Oncology • Solid Tumor • Testicular Cancer • Thoracic Cancer

Fennec Pharmaceuticals Reports First Quarter 2026 Financial Results and Provides Business Update (The Manila Times) - "For the first quarter of 2026, the Company recorded net product sales of approximately $15.1 million compared to $8.8 million in the first quarter of 2025. The increase in sales is attributable to growth across PEDMARK accounts, including new accounts in the AYA population. Four abstracts evaluating PEDMARK were accepted as part of the 2026 ASCO Annual Meeting program, taking place May 29-June 2, 2026 in Chicago, IL. Initiated Third Institution-Led Clinical Study Evaluating PEDMARK in Adolescent and Young Adult (AYA) and Adult Patients with Head and Neck and Testicular Cancers."

Clinical data • Commercial • Germ Cell Tumors • Solid Tumor

Fennec Pharmaceuticals Presents Real World Data Supporting the Integration and Clinical Use of PEDMARK in Treating Adults with Head & Neck Cancers (GlobeNewswire) - "...Data...were presented as a digital poster at the 2026 Multidisciplinary Head and Neck Cancers Symposium (MHNCS)....Findings from a multi-institutional retrospective review of 15 adults with head and neck cancers (HNC) showed that PEDMARK could be safely given ≥six hours after cisplatin dosing and was easy to incorporate into the real-world care plan for adults with HNC. This strict post-cisplatin timing is a validated approach intended to preserve cisplatin antitumor activity and no disruption to curative-intent cisplatin-based treatment delivery was observed as part of the study review."

Real-world • Retrospective data • Head and Neck Cancer

Ph. I/II Sodium Thiosulfate for OtoProtection During Cisplatin (STOP-CIS) (clinicaltrials.gov) - P1/2 | N=25 | Not yet recruiting | Sponsor: University of Arizona

New P1/2 trial • Genito-urinary Cancer • Head and Neck Cancer • Oncology • Solid Tumor • Testicular Cancer • Thoracic Cancer

Bridging the Translational Valley of Death in Auditory Gene and Drug Therapies (ARO 2026) - "The only FDA-approved drug, sodium thiosulfate (PEDMARK®), is limited to preventing cisplatin-induced ototoxicity in pediatric patients. The translational gap in auditory therapeutics is especially acute for academic startups, and reflects intertwined scientific, methodological, cultural, and operational challenges. Success requires early and sustained integration of basic scientists with translational experts, including toxicologists, pharmacologists, and regulatory specialists, so that promising discoveries can be de-risked and advanced efficiently toward clinical application. Consistently bridging the translational valley for auditory therapies will require strategic use of large animal models, novel translational biomarkers, and patient-derived systems to improve human relevance."

Developmental Disorders • Gene Therapies • Infectious Disease • Otorhinolaryngology

Testing the Addition of Pedmark to Cisplatin Chemotherapy for Reducing Drug-Induced Ear Damage in Men With Stage II-III Metastatic Testicular Germ Cell Tumors (clinicaltrials.gov) - P1 | N=44 | Recruiting | Sponsor: City of Hope Medical Center | Not yet recruiting ➔ Recruiting | Trial completion date: Feb 2030 ➔ Jan 2031 | Trial primary completion date: Feb 2030 ➔ Jan 2031

Enrollment open • Trial completion date • Trial primary completion date • Genito-urinary Cancer • Germ Cell Tumors • Oncology • Otorhinolaryngology • Solid Tumor • Testicular Cancer • Testicular Non-seminoma • Testicular Seminoma

Severe Hypernatremia and Transient Hallucinations After Sodium Thiosulfate (Pedmark) in Pediatric Intracranial Germinoma With Central Diabetes Insipidus. (PubMed, Pediatr Blood Cancer) - No abstract available

Journal • Germ Cell Tumors • Metabolic Disorders • Pediatrics

Testing the Addition of Pedmark to Cisplatin Chemotherapy for Reducing Drug-Induced Ear Damage in Men With Stage II-III Metastatic Testicular Germ Cell Tumors (clinicaltrials.gov) - P1 | N=44 | Not yet recruiting | Sponsor: City of Hope Medical Center

New P1 trial • Genito-urinary Cancer • Germ Cell Tumors • Oncology • Otorhinolaryngology • Solid Tumor • Testicular Cancer • Testicular Non-seminoma • Testicular Seminoma

Norgine strengthens rare disease portfolio with acquisition of Theravia (PRNewswire) - "Norgine and Theravia announced today that they have entered into a definitive agreement under which Norgine will acquire Theravia, an international pharmaceutical company specialising in cutting-edge treatments for patients with rare and debilitating conditions....With the acquisition of Theravia, Norgine will now have...core products in its rare disease portfolio (PEDMARQSI, eflornithine, mavorixafor, SIKLOS) thereby comprising a franchise of critical scale with the ability to be a key growth driver in the medium-to-long-term."

M&A • Dermatology • Genetic Disorders • Hematological Disorders • Otorhinolaryngology

Fennec Pharmaceuticals Reports Fourth Quarter and Full-Year 2024 Financial Results and Provides Business Update (GlobeNewswire) - "Achieved Full-Year PEDMARK Net Product Sales of $29.6 Million, Up 40% Year-Over-Year, and Generated PEDMARK Q4 2024 Net Product Sales of $7.9 Million....Ex-U.S. Opportunities for PEDMARK: In Japan, the investigator-initiated clinical trial (STS-J01) in Japan evaluating PEDMARK fully enrolled in Q4 2024 and the results of the trial are expected in the second half of 2025 with the potential evaluation for registration of PEDMARK in Japan thereafter."

P2 data • Sales • Oncology • Solid Tumor

Real-World Experience Using Sodium Thiosulfate Pentahydrate Off-Label for Cisplatin Otoprotection in Children, Adolescents, and Young Adults. (PubMed, Pediatr Blood Cancer) - "STS-P off-label for otoprotection following cisplatin was tolerable in a real-world setting across age groups and cancer types. Formal testing in larger studies of different STS formulations is needed to explore possible differences in toxicity and CIHL prevention."

Journal • Real-world evidence • Oncology • Otorhinolaryngology • Pediatrics • Solid Tumor

Fennec Pharmaceuticals Announces Commercial Launch of PEDMARQSI In Germany (GlobeNewswire) - "Fennec Pharmaceuticals Inc...announced that Norgine Pharmaceuticals Ltd., a leading European specialist pharmaceutical company, has commercially launched PEDMARQSI (sodium thiosulfate injection) in Germany....The data from two open-label, randomized Phase 3 trials, SIOPEL 6 (pivotal) and the Clinical Oncology Group (COG) Protocol ACCL0431, demonstrated an approximate 50% reduction in the occurrence of cisplatin-induced ototoxicity in patients treated with cisplatin and sodium thiosulfate vs. those treated with cisplatin alone."

Launch Europe • Otorhinolaryngology • Solid Tumor

Fennec Pharmaceuticals Announces Pedmarqsi Positive Recommendation by NICE for the Prevention of Cisplatin-Induced Hearing Loss in England and Wales (GlobeNewswire) - "Fennec Pharmaceuticals Inc...announced that Norgine Pharmaceuticals Ltd...has received positive final draft guidance from National Institute for Health and Care Excellence (NICE) recommending PEDMARQSI for the prevention of cisplatin-induced hearing loss in patients (aged 1 month to 17 years) with localized, non-metastatic, solid tumors."

NICE • Otorhinolaryngology

Fennec Pharmaceuticals Reports Third Quarter 2024 Financial Results and Provides Business Update (GlobeNewswire) - "Increasing Momentum and Successful Reimbursement in the Adolescent and Young Adult (AYA) Segment Following Strategic Investments to Drive Awareness of Ototoxicity & Adoption of PEDMARK; PEDMARQSI is expected to be available in select markets in Europe in the coming months, which will generate additional revenue for Fennec in 2025 and beyond; Investigator-initiated clinical trial (STS-J01) in Japan evaluating PEDMARK fully enrolled in October 2024...Results of the trial are expected in 2025 with the potential evaluation for registration of PEDMARK in Japan thereafter."

Launch Europe • Reimbursement • Trial status • Oncology • Solid Tumor

THE VALUE AND CHALLENGES OF LOCAL APPLICATION OF SODIUM-THIOSULFATE (STS) AS OTOPROTECTANT IN CISPLATIN-TREATED CANCER PATIENTS: PERSPECTIVES FOR CHILDREN BASED ON A LITERATURE REVIEW (SIOP 2024) - "The burden of intratympanic procedures in children (who require recurrent sedation), together with the low level of evidence of efficacy, leads to the conclusion that (for now) this strategy is unfeasible for otoprotection in cisplatin-exposed children with cancer. STS* = Pedmarqsi/Pedmark (Fennec compound)"

Clinical • Review • Anesthesia • Oncology • Pediatrics

Effect of sodium thiosulfate anhydrous on cisplatin-induced ototoxicity in pediatric cancers: Turkish compassionate use treatment protocol—Updated results. (ASCO 2024) - "Background: Cisplatin induced ototoxicity (CIO), with permanent hearing loss is observed in >60% pediatric patients in Turkey. PEDMARK was well tolerated, provided via a Turkish CUP to reduce the CIO in pediatric patients with nonmetastatic solid tumors. No hearing loss was observed/ detected post-treatment and the tumor outcomes were consistent with the Phase 3 studies. This is very encouraging."

Clinical • Brain Cancer • Gastrointestinal Cancer • Hepatoblastoma • Hepatology • Medulloblastoma • Nasopharyngeal Carcinoma • Oncology • Otorhinolaryngology • Pediatrics • Solid Tumor

Fennec Pharmaceuticals Reports First Quarter 2024 Financial Results and Provides Business Update (GlobeNewswire) - "Achieved PEDMARK net product revenue of approximately $7.4 million in the first quarter of 2024 and total net revenues of $25.4 million, which is inclusive of $18.0 million in revenue from the Norgine transaction. Amended permanent J-Code, which became effective on April 1, 2024, now clearly specifies PEDMARK from other formulations of sodium thiosulfate (STS)."

Reimbursement • Sales • Oncology • Solid Tumor

Fennec Pharmaceuticals Reports Full Year and Fourth Quarter 2023 Financial Results and Provides Business Update (GlobeNewswire) - "Entered into exclusive licensing agreement to commercialize PEDMARQSI in Europe, Australia and New Zealand. Fennec received approximately $43 million upfront and has the potential to receive up to approximately $230 million in additional commercial and regulatory milestones, and double-digit tiered royalties up to the mid-twenties....Net product sales of $21.3 million in fiscal 2023 compared to $1.5 million in 2022. The Company had gross profit of $20.0 million for fiscal year ended 2023. The increase in sales reflects strong growth in new patient starts and accounts."

Licensing / partnership • Sales • Oncology • Solid Tumor

Fennec Pharmaceuticals and Norgine Enter into Exclusive Licensing Agreement to Commercialize PEDMARQSI in Europe, Australia, and New Zealand (GlobeNewswire) - "Fennec Pharmaceuticals...and Norgine...announced an exclusive licensing agreement under which Norgine will commercialize PEDMARQSI in Europe, Australia and New Zealand. PEDMARQSI is the first and only approved therapy in the EU and U.K. for the prevention of ototoxicity (hearing loss) induced by cisplatin chemotherapy in patients 1 month to < 18 years of age with localized, non-metastatic solid tumors. Under the terms of the licensing agreement, Fennec will receive €40 million in upfront consideration and up to €210 million in additional commercial and regulatory milestone payments and double-digit tiered royalties on net sales of PEDMARQSI in the licensed territories up to the mid-twenties. Norgine will be responsible for all commercialization activities in the licensed territories..."

Licensing / partnership • Solid Tumor

FDA Issues Reminder of Non-Substitution of PEDMARK (sodium thiosulfate injection) for Pediatric Patients Receiving Cisplatin (GlobeNewswire) - "Fennec Pharmaceuticals Inc...announced that the U.S. Food and Drug Administration (FDA) has issued a public reminder to healthcare providers that PEDMARK (sodium thiosulfate injection) is not substitutable with other sodium thiosulfate products as explicitly directed in its prescribing label. PEDMARK is the first and only FDA approved therapy indicated to reduce the risk of ototoxicity (e.g., permanent hearing loss) associated with cisplatin in pediatric patients 1 month of age and older with localized, non-metastatic solid tumors...The FDA stated that such substitutions pose potential health risks, including: Potassium chloride exposure which, at high doses, can lead to increased risk of acute cardiac events and other serious adverse reactions. Potassium chloride is not present in PEDMARK....Sodium nitrite is co-packaged with sodium thiosulfate as a separate vial in some products; it is not present in PEDMARK."

FDA event • Oncology