Chemotherapy-induced peripheral neuropathic pain

Abstract

### Key points Chemotherapy-induced peripheral neuropathy (CIPN) is due to the toxicity of the chemotherapeutic drugs and mainly affects the peripheral nervous system. More than 50% of patients are surviving longer than 10 yr since their diagnosis of cancer and a good proportion of them have either disease-related or treatment-related chronic pain. The severity of the resultant neuropathy depends on the drugs used, duration of treatment, or nerve damage either by cancer itself or due to any pre-existing conditions such as diabetic or alcoholic neuropathy. There are no major differences in the incidence between the sexes. The objective of the article is to discuss the nature of the peripheral neuropathy associated with chemotherapeutic agents, their clinical features, evaluation, and subsequent clinical management. The drugs most commonly associated with CIPN are platinum compounds (cisplatin, carboplatin, and oxaliplatin), taxanes (paclitaxel, docetaxel), vinca alkaloids (vincristine, vinblastine), epothilones (ixabepilone), bortezomib, and thalidomide along with its analogues. Combination of two or more of these agents can result in higher possibility of developing peripheral neuropathy. For example, when combined with cisplatin or carboplatin, paclitaxel neuropathy may be encountered in 70% of patients. ### Platinum compounds These are commonly used for lung, ovarian, and bowel cancers and the mechanism of action is by interacting with …