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  • Review Article
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Chemotherapy-induced peripheral neurotoxicity

Nature Reviews Neurology volume 6, pages 657–666 (2010)Cite this article

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Abstract

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a common, potentially severe and dose-limiting adverse effect of cancer treatment; however, the effects of CIPN on the daily life of individuals are not completely understood. CIPN can be induced by several types of drugs that are widely used in the treatment of solid and hematological malignancies. Our knowledge of the mechanisms underlying CIPN is incomplete, but structural properties of the various neurotoxic compounds might contribute to variations in the pathogenetic mechanisms of damage, in addition to the type of neurotoxicity, severity of the clinical condition, and incidence of CIPN. No drugs capable of preventing the occurrence of CIPN or ameliorating its long-term course are available, and chemotherapy schedule modification is often required to limit its severity, which could potentially prevent patients from receiving the most effective treatment for cancer. Moreover, symptomatic therapy is often largely ineffective in reducing CIPN symptoms. In this Review, the mechanistic and clinical aspects of this unpredictable condition are considered, along with the controversial aspects of CIPN, including the onset mechanisms associated with the different drug types, assessment of the patient's condition, and the current status of neuroprotection and treatment options.

Key Points

  • Chemotherapy-induced peripheral neurotoxicity (CIPN) frequently occurs during cancer treatment, and can necessitate chemotherapy schedule modification

  • CIPN can be long-lasting, or even permanent in the worst cases

  • Reliable assessment of CIPN is still a matter of debate

  • No drugs are available to prevent CIPN or reduce its long-term effects, and symptomatic treatment is frequently ineffective

  • Collaboration among oncologists, neurologists and patients is essential to establish a 'virtuous alliance' against CIPN

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Authors and Affiliations

  1. Department of Neuroscience and Biomedical Technologies, University of Milano-Bicocca, Via Cadore 48, 20052, Monza, Italy

    Guido Cavaletti & Paola Marmiroli

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  1. Guido Cavaletti
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  2. Paola Marmiroli
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The authors equally contributed to the research data, content evaluation, writing and editing of the manuscript before submission.

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Correspondence to Guido Cavaletti.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Table 1

CIPN-related terms as reported in the National Cancer Institute—Common Terminology Criteria version 3.0 (NCI-CTCAE v3.0)* (DOC 55 kb)

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Cavaletti, G., Marmiroli, P. Chemotherapy-induced peripheral neurotoxicity. Nat Rev Neurol 6, 657–666 (2010). https://doi.org/10.1038/nrneurol.2010.160

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