Critical Reviews in Oncology/Hematology - Chemotherapy-induced peripheral neurotoxicity (CIPN): An update
Abstract
The
peripheral nervous system can be vulnerable to the toxic action of
several drugs since it is not protected as effectively as the central
nervous system from noxious exogenous agents. Drug-induced neurotoxicity
can affect the nerve fibers or the neuronal bodies (generally the
dorsal root ganglia of the primary sensory neurons). Among the
neurotoxic drugs antineoplastic agents represent a major clinical
problem, given their widespread use and the potential severity of their
toxicity. In fact, the peripheral neurotoxicity of antineoplastic agents
frequently represents one of their dose-limiting side effects.
Moreover, even when antineoplastic agents’ peripheral neurotoxicity is
not dose-limiting, its onset may severely affect the quality of life of
cancer patients and cause chronic discomfort.
Among the anticancer
chemotherapy drugs, platinum derivates, antitubulins, thalidomide and
bortezomib can induce the most severe effects on the peripheral nervous
system of the treated patients. Therefore, we will review the features
of chemotherapy-induced peripheral neurotoxicity (CIPN) resulting from
the administration of these drugs with a focus on new classes of
promising antineoplastic agents, such as epothilones and proteasome
inhibitors.