Chemotherapy-Induced Neuropathic Pain and Underlying Mechanisms

Abstract

One of the most common issues caused by antineoplastic agents is chemotherapy-induced peripheral neuropathy (CIPN). In patients, CIPN is a sensory neuropathy accompanied by various motor and autonomic changes. With a high prevalence of cancer patients, CIPN is becoming a major problem for both cancer patients and for their health care providers. Nonetheless, there are lacking effective interventions preventing CIPN and treating the CIPN symptoms. Several current studies have demonstrated the cellular and molecular signaling pathways leading to CIPN using experimental models and the beneficial effects of some interventions on the CIPN symptoms related to those potential mechanisms. This review summarizes results obtained from recent human and animal studies, which include the abnormalities in mechanical and temperature sensory responses following chemotherapeutic agents such as representative bortezomib, oxaliplatin and paclitaxel. The underlying mechanisms of CIPN at cellular and molecular levels are also discussed for additional in-depth studies needed to be better explored. A better understanding of the risk factors and fundamental mechanisms of CIPN is needed to design effective preventive drugs and therapeutic strategies. Overall, this paper reviews the basic picture of CIPN and the signaling mechanisms of the most common antineoplastic agents and potential approaches to be considered to alleviate neuropathic pain observed during chemotherapy.