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Peripheral neuropathy: from guidelines to clinical practise.

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Chemotherapy-induced peripheral neuropathy (CIPN) lacks effective prevention. Emerging biomarkers like serum neurofilaments and promising interventions such as physical exercise may improve patient care.

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Area of Science:

  • Oncology
  • Neurology
  • Pharmacology

Background:

  • Chemotherapy-induced peripheral neuropathy (CIPN) is a significant treatment complication.
  • Current objective grading and prevention strategies for CIPN are lacking.
  • Subjective assessments hinder reproducible CIPN evaluation.

Purpose of the Study:

  • To review recent advancements in understanding and managing CIPN.
  • To explore potential biomarkers for early detection of axonal damage.
  • To evaluate promising therapeutic and preventive strategies for CIPN.

Main Methods:

  • Review of preclinical and clinical studies on CIPN.
  • Analysis of emerging biomarkers for axonal damage.
  • Evaluation of therapeutic interventions including physical exercise and pharmacotherapy.

Main Results:

  • Serum neurofilaments show potential as biomarkers for axonal damage in CIPN.
  • SARM1 pathway is implicated in toxic neuropathy.
  • Physical exercise, sensorimotor training, and whole-body vibration show promise for functional recovery.
  • Gabapentinoids demonstrated no significant benefit in a systematic review.

Conclusions:

  • Further research is needed for biomarker quantification before CIPN symptom onset.
  • Biomarker development can aid in early axonal degeneration detection.
  • Patient-centered care integrating new findings is crucial for managing CIPN.