Bortezomib-induced peripheral neurotoxicity: an update

Area of Science:

• Neuroscience
• Pharmacology
• Oncology

Background:

• Bortezomib-induced peripheral neuropathy (BIPN) is a common dose-limiting toxicity in cancer therapy.
• The precise mechanisms underlying BIPN pathogenesis remain incompletely understood.
• Existing assessment methods for BIPN can lead to ambiguous interpretations of incidence and severity.

Purpose of the Study:

• To critically review current understanding of BIPN characteristics and treatment options.
• To emphasize key pathogenic factors contributing to BIPN development.
• To highlight the need for improved diagnostic and therapeutic strategies.

Main Methods:

• Review of existing literature on bortezomib-induced peripheral neuropathy.
• Analysis of proposed pathogenetic mechanisms, including proteasome inhibition and cellular signaling.
• Evaluation of current diagnostic criteria and treatment approaches.

Main Results:

• BIPN is characterized as a dose-dependent, painful sensory neuronopathy.
• Key pathogenetic factors include proteasome inhibition, mitochondrial dysfunction, and dysregulation of NF-κB and BDNF.
• Patients with prior neurotoxic exposure are at higher risk for severe BIPN.
• Current interventions are primarily symptomatic for pain management.

Conclusions:

• Effective preventive pharmacological treatments for BIPN are currently lacking.
• Symptomatic management and dose modification algorithms are crucial for managing BIPN.
• Further research utilizing diverse approaches is essential for elucidating BIPN pathogenesis and developing targeted interventions.