Chemotherapy-induced peripheral neurotoxicity.

Abstract

Chemotherapy-induced peripheral neurotoxicity (CIPN) is clinically relevant because it is frequent, it might be dose-limiting, it affects the cancer survivors' quality of life, and no treatment is available. Better understanding of CIPN might lead to an improvement in its management. Conventional chemotherapy is a well known cause of peripheral neurotoxicity, which mostly manifest with sensory impairment. CIPN has also been described for new, highly effective compounds, which are, therefore, limited in their more widespread use. Even several 'targeted drugs', which should be free from the risk of CIPN by definition, are neurotoxic, occasionally inducing severe motor impairment. Precise definition of CIPN clinical features can be obtained by only using validated outcome measures. Therefore, a major aim of clinical research is to standardize CIPN assessment, also considering that healthcare providers and patients frequently have a different perception of CIPN severity. A second major aim in clinical research is to maintain a high level of attention to the possible neurotoxicity of drugs more recently introduced into clinical practice. Preclinical studies are of pivotal importance to identify druggable targets for pharmacological intervention in order to prevent or limit CIPN.