Current Research Activities Ototoxicity is a common side effect of platinum-based chemotherapy that leads to significant negative health and psychosocial consequences among adult cancer survivors (Miaskowski et al. 2018; Dillard et al. 2022). Prospectively monitoring patients with cancer for early signs of ototoxicity provides the opportunity to mitigate its adverse effects when the oncologist is able to modify drug treatment, and/or the audiologist can deliver timely rehabilitation (ASHA 1994; AAA 2009). Unfortunately, significant barriers exist to integrating audiology supportive services into oncologic care. Principal among these are barriers related to care and referral coordination with oncology, audiology workload, and lack of protocols. Development of interventions is further hampered by uncertain pathophysiology and variable patient susceptibility to ototoxicity, particularly as it relates to the development of tinnitus and difficulties understanding speech in noise. The result is that ototoxicity management (OtoM) as delivered currently in VA is elective care that occurs sporadically and fails to inform the patient’s ototoxicity risk stratification, oncologic treatment or survivorship plan (Konrad-Martin et al. 2021, 2023). The objectives of Dr. Konrad-Martin’s program of research are to: (i) construct tools to forecast individual patient susceptibility to ototoxic hearing loss and tinnitus; (ii) test new hypotheses developed in animal models, about the cochlear changes that trigger tinnitus and temporal processing problems in humans; and (iii) characterize ototoxicity and OtoM from the perspectives of the patient and provider. For this research, patients receiving cisplatin, carboplatin, or oxaliplatin are providing behavioral and physiological measures of auditory function before, during, and after treatment. A subset contribute a blood sample for a genetic association pilot study. i. Forecasting model development. We have developed a prognostic model to mathematically transform the patient’s personal and treatment features into the expected post-treatment audiogram, which can be expressed on a variety of measurement scales to address the clinical concern for patients, audiologists and oncologists (McMillan et al. in progress). Into this model, we have incorporated population-based data from unexposed controls on normal test-retest variability in pure tone thresholds. For Dr. Konrad-Martin’s SPiRE, model predictors additionally include the presence and numbers of specific single nucleotide polymorphisms within four genes selected for their potential association with cisplatin ototoxicity, including: ACYP2 (Xu et al., 2015); COMT (Hagleitner et al., 2014); TPMT (Ross et al., 2009); and TRPV1 (Jiang et al., 2019). ii. Relating ototoxic symptoms to the underlying auditory injury. A combination of wideband acoustic reflex (AR) amplitude growth (Westman et al., 2021), and distortion product otoacoustic emission (DPOAE) levels is being used ...