[Chemotherapy-induced peripheral neuropathy: an unresolved issue]

Area of Science:

• Oncology
• Neurology
• Pharmacology

Context:

• Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent neurological complication affecting one-third of chemotherapy patients.
• CIPN significantly impacts functional capacity and quality of life, often leading to chemotherapy dose modification or cessation.
• Bortezomib and oxaliplatin are examples of agents with a notable risk of inducing CIPN.

Purpose:

• To review current literature on the pathogenesis, incidence, risk factors, diagnosis, characteristics, and management of CIPN.
• To analyze recent advances and relevant issues concerning CIPN.
• To highlight the need for improved assessment tools and risk stratification for CIPN.

Summary:

• Research is advancing in understanding CIPN pathophysiology and identifying patient-specific risk factors, with potential for genotype-based risk assessment.
• Current assessment tools for CIPN are not standardized, and many purported neuroprotective agents have failed in large clinical trials.
• Early detection and dose management of neurotoxic agents are crucial for minimizing CIPN, given the absence of effective prophylactic or symptomatic treatments.

Impact:

• Highlights the critical need for neurological monitoring in patients receiving neurotoxic chemotherapy, especially those with pre-existing neuropathy.
• Emphasizes the necessity for developing reliable methods for assessing CIPN to guide clinical management.
• Underscores the current limitations in effective treatments, reinforcing the importance of proactive patient management strategies.