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Chemotherapy and peripheral neuropathy

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Abstract

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a major dose-limiting side effect of many anti-cancer agents, including taxanes, platinums, vinca alkaloids, proteasome inhibitors, immunomodulatory drugs, and antibody–drug conjugates. The resultant symptoms often persist post treatment completion and continue to impact on long-term function and quality of life for cancer survivors. At present, dose reduction remains the only strategy to prevent severe neuropathy, often leading clinicians to the difficult decision of balancing maximal treatment exposure and minimal long-lasting side effects. This review examines the clinical presentations of CIPN with each class of neurotoxic treatment, describing signs, symptoms, and long-term outcomes. We provide an update on the proposed mechanisms of nerve damage and review current data on clinical and genetic risk factors contributing to CIPN development. We also examine recent areas of research in the treatment and prevention of CIPN, with specific focus on current clinical trials and consensus recommendations for CIPN management.

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Funding

This study was supported by a Cancer Institute NSW Program Grant (14/TPG/1–05) and a National Health and Medical Research Council of Australia (NHMRC) Project Grant (#1080521). SBP is supported by a NHMRC Career Development Fellowship (#1148595). MCK receives funding from NHMRC Program Grant (#1132524), Partnership Project (#1153439) and is supported by a NHMRC Practitioner Fellowship (#1156093).

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  1. Faculty of Medicine and Health, School of Medical Sciences, Brain and Mind Centre, The University of Sydney, CamperdownSydney, NSW, 2050, Australia

    Tiffany Li, Matthew C. Kiernan & Susanna B. Park

  2. Prince of Wales Clinical School, University of New South Wales, Kensington, Australia

    David Mizrahi & David Goldstein

  3. The Daffodil Centre, The University of Sydney, Sydney, Australia

    David Mizrahi

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Li, T., Mizrahi, D., Goldstein, D. et al. Chemotherapy and peripheral neuropathy. Neurol Sci 42, 4109–4121 (2021). https://doi.org/10.1007/s10072-021-05576-6

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