Oxaliplatin-induced peripheral neuropathy: from pathogenesis to treatment

Oxaliplatin, a third-generation platinum-based chemotherapeutic agent, has emerged as a widely adopted therapeutic option for the management of multiple cancer types. Oxaliplatin-induced peripheral neuropathy (OIPN) represents a prevalent and clinically relevant adverse effect of oxaliplatin-based chemotherapy, frequently prompting treatment dose reduction or even therapy discontinuation. OIPN is characterized by two distinct features of acute onset and chronic accumulation and shows a high degree of sensitivity to cold stimuli. The pathogenesis of OIPN is complex, involving multiple targets and various cell types contributing to neuropathy. Additionally, the mechanisms of OIPN may interfere with and superimpose on each other, necessitating combination therapies for effective management. However, despite extensive preclinical and clinical investigations, no preventive therapies have demonstrated significant clinical efficacy and established treatment for painful OIPN remain limited. It is of paramount importance to comprehensively understand and analyze OIPN. The present review summarizes the most recent advances in the field of studies on OIPN, the overview of pathogenesis, incidence, risk factors, clinical syndrome, and management of OIPN.