A commentary notes that numerous questions still remain concerning cisplatin otoprotection. First, should cisplatin be offered to all patients, irrespective of their diagnosis or their baseline characteristics? It notes that growing evidence suggests individual susceptibility to cisplatin ototoxicity is variable, and this susceptibility may have a strong genetic component, but whether this approach should be limited to patients with a genetic susceptibility remains to be investigated. Second, can the use of sodium thiosulfate possibly optimise the delivery of the planned dose of cisplatin? Lastly, can sodium thiosulfate be considered for patients with advanced or disseminated disease?