Treatment and care of neurotoxicity from taxane anticancer agents

Taxane anticancer agents play a central role in drug therapy for breast cancer today; however, they have a dose-limiting neurotoxicity that is difficult to prevent and treat. To protect against this neurotoxicity it is important to avoid large doses greater than 200 mg/m2, and to adopt 24-hour administration regimens. Care is also needed with regard to the cumulative dose. Glutamine and amitriptyline are two of the very few drugs that have been found to be clinically effective against drug-induced peripheral neuropathy. Drugs are discontinued if neuropathy appears. If administration is to be later restarted, it is recommended that combined use of glutamine or amitriptyline be considered and that patients be given guidance for daily life.