Chemotherapy-induced peripheral neuropathy: Mechanisms of toxicity and potential natural compounds-based therapeutics

Platinum-based drugs, such as cisplatin, carboplatin, and oxaliplatin, are increasingly being used to treat a variety of cancers, including lung, ovarian, testicular, and bladder cancer, as well as a secondary treatment for other types of cancer. These drugs primarily act by targeting the DNA of cancer cells, causing DNA damage that inhibits cell division and slows cancer progression. However, the mechanism can also lead to specific side effects, such as neuropathy. Chemotherapy-induced peripheral neuropathy (CIPN) caused by platinum drugs is a common and severe toxicity issue that significantly impacts the quality of life of affected patients. CIPN manifests as damage to the peripheral nerves, resulting in impaired sensation, movement limitations, and disruptions in autonomic function. While the exact mechanisms underlying CIPN are not entirely understood, it is believed to involve complex pathways, including oxidative stress, inflammation, and disruption of neuronal function. Identifying effective interventions to mitigate CIPN is crucial, as current management strategies have had limited success. Recent research has focused on plant-based compounds, which have shown promising results in both preclinical and clinical studies. To this end, our review highlights key toxic mechanisms of CIPN caused by platinum-based drugs and identifies effective natural compound-based interventions, offering valuable insights into treatment strategies for CIPN management.