A review on oxaliplatin-induced peripheral nerve damage

Area of Science:

• Oncology
• Neuroscience
• Pharmacology

Background:

• Platinum compounds, including oxaliplatin (OXL), are vital chemotherapy agents for solid tumors like colorectal cancer (CRC).
• Oxaliplatin-induced peripheral neuropathy (OXLIPN) is a significant dose-limiting toxicity, manifesting as acute and chronic forms.
• The underlying mechanisms involve calcium chelation, voltage-gated sodium channel alteration, and impaired cellular metabolism in dorsal root ganglia.

Purpose of the Study:

• To comprehensively review the pathogenesis, incidence, risk factors, and diagnostic methods of OXLIPN.
• To discuss the clinical characteristics and current management strategies for OXLIPN.
• To identify potential neuroprotective agents and highlight future research directions for OXLIPN.

Main Methods:

• Review of existing literature on oxaliplatin and its neurotoxicity.
• Analysis of proposed mechanisms for acute and chronic OXLIPN.
• Examination of clinical data on neuroprotective agent efficacy.

Main Results:

• OXLIPN presents as a symmetric, axonal, sensory distal neuronopathy, typically without motor involvement.
• Incidence is influenced by treatment schedule, dosage, cumulative dose, and infusion time.
• Current neuroprotective strategies show controversial clinical results.

Conclusions:

• OXLIPN is a common and complex side effect of oxaliplatin chemotherapy.
• Accurate diagnosis relies on clinical examination and nerve conduction studies.
• Further research is needed to establish effective neuroprotective treatments for OXLIPN.