Vinca alkaloids, thalidomide, and eribulin are widely used to treat patients with childhood acute lymphoblastic leukemia (ALL), adults affected by multiple myeloma and locally invasive or metastatic breast cancer, respectively. However, soon after their introduction into clinical practice, chemotherapy‐induced peripheral neurotoxicity (CIPN) emerged as their main non‐hematological and among dose‐limiting adverse events. It is generally perceived that vinca alkaloids and the antiangiogenic agent thalidomide are more neurotoxic, compared to eribulin. The exposure to these chemotherapeutic agents is associated with an axonal, length‐dependent, sensory polyneuropathy of mild to moderate severity, whereas it is considered that the peripheral nerve damage, unless severe, usually resolves soon after treatment discontinuation. Advanced age, high initial and prolonged dosing, coadministration of other neurotoxic chemotherapeutic agents and pre‐existing neuropathy are the common risk factors. Pharmacogenetic biomarkers might be used to define patients at increased susceptibility of CIPN. Currently, there is no established therapy for CIPN prevention or treatment; symptomatic treatment for neuropathic pain and dose reduction or withdrawal in severe cases is considered, at the cost of reduced cancer therapeutic efficacy. This review critically examines the pathogenesis, epidemiology, risk factors (both clinical and pharmacogenetic), clinical phenotype and management of CIPN as a result of exposure to vinca alkaloids, thalidomide and its analogue lenalidomide as also eribulin.

中文翻译：

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长春花生物碱、沙利度胺和艾日布林引起的周围神经毒性：从发病机制到治疗。


长春花生物碱、沙利度胺和艾日布林分别广泛用于治疗儿童急性淋巴细胞白血病 (ALL)、成人多发性骨髓瘤和局部侵袭性或转移性乳腺癌患者。然而，在引入临床实践后不久，化疗引起的周围神经毒性（CIPN）成为其主要的非血液学和剂量限制性不良事件。人们普遍认为，与艾日布林相比，长春花生物碱和抗血管生成剂沙利度胺的神经毒性更大。接触这些化疗药物与轻度至中度严重程度的轴突、长度依赖性、感觉性多发性神经病有关，而周围神经损伤，除非严重，通常在治疗停止后很快就会消失。高龄、初始高剂量和长期用药、合用其他神经毒性化疗药物以及既往存在神经病变是常见的危险因素。药物遗传学生物标志物可用于定义 CIPN 易感性​​增加的患者。目前，尚无预防或治疗 CIPN 的既定疗法；考虑对神经性疼痛进行对症治疗，严重时考虑减少剂量或停药，但代价是癌症治疗效果降低。本综述严格审查了因暴露于长春花生物碱、沙利度胺及其类似物来那度胺以及艾日布林而导致的 CIPN 的发病机制、流行病学、危险因素（临床和药物遗传学）、临床表型和治疗。