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Neurological complications of new chemotherapy agents
Alicia M Zukas1, David Schiff2,3
1Department of Neurology, Virginia Commonwealth University, Richmond, Virginia.
Abstract:
This last decade has yielded more robust development of cancer treatments and first-in-class agents than ever before. Since 2006, nearly one hundred new drugs have received regulatory approval for the treatment of hematological and solid organ neoplasms. Moreover, older conventional therapies have received approval for new clinical indications and are being used in combination with these newer small-molecule targeted treatments. The nervous system is vulnerable to many of the traditional cancer therapies, manifesting both already well-described acute and chronic toxicities. However, newer agents may produce toxicities that may seem indistinguishable from the underlying cancer. Early recognition of neurotoxicities from new therapeutics is vital to avoid irreversible neurological injury. This review focuses on cancer therapies in use in the last 10 years and approved by the FDA from January 2006 through January 1, 2017.
Insights
New cancer treatments offer improved efficacy but can cause neurological side effects. Early identification of these neurotoxicities is crucial to prevent permanent damage from novel cancer therapies.
Area of Science:
- Oncology
- Neuro-oncology
- Pharmacology
Background:
- Cancer treatment advancements have led to nearly 100 new drug approvals since 2006.
- Conventional therapies are increasingly used in combination with novel small-molecule targeted treatments.
- The nervous system is susceptible to both traditional and novel cancer therapies, presenting unique toxicities.
Purpose of the Study:
- To review neurotoxicities associated with cancer therapies approved by the FDA between January 2006 and January 2017.
- To highlight the importance of early recognition of treatment-induced neurotoxicity.
- To differentiate potential neurotoxicities from cancer progression symptoms.
Main Methods:
- Literature review of FDA-approved cancer therapies from 2006-2017.
- Focus on agents with potential or known neurological side effects.
- Analysis of reported acute and chronic neurotoxicities.
Main Results:
- Numerous new cancer drugs have been approved, expanding treatment options.
- Both conventional and novel agents can induce neurological toxicities.
- Some newer agents' toxicities may mimic cancer progression, complicating diagnosis.
Conclusions:
- Early detection of neurotoxicity is vital for managing cancer patients.
- Understanding the neurological side effect profiles of new cancer drugs is essential.
- Prompt intervention can prevent irreversible neurological injury in patients undergoing cancer treatment.