Abstract
Platinum agents (cisplatin, carboplatin, and oxaliplatin) are a class of chemotherapy agents that have a broad spectrum of activity against several solid tumors. Toxicity to the peripheral nervous system is the major dose-limiting toxicity of at least some of the platinum drugs of clinical interest. Among the platinum compounds in clinical use, cisplatin is the most neurotoxic, inducing mainly sensory neuropathy of the upper and lower extremities. Carboplatin is generally considered to be less neurotoxic than cisplatin, but it is associated with a higher risk of neurological dysfunction if administered at high dose or in combination with agents considered to be neurotoxic. Oxaliplatin induces two types of peripheral neuropathy, acute and chronic. The incidence of oxaliplatin-induced neuropathy is related to various risk factors such as treatment schedule, cumulative dose, and time of infusion. To date, several neuroprotective agents including thiol compounds, vitamin E, various anticonvulsants, calcium-magnesium infusions, and other nonpharmacological strategies have been tested for their ability to prevent platinum-induced neurotoxicity with controversial results. Further studies on the prevention and treatment of neurotoxicity of platinum analogues are warranted.
Highlights
Platinum drugs are among the most important cytotoxic drugs available to oncologists
This paper aims to highlight the neurotoxicity of commonly used platinum agents and published data on certain compounds that have been reported to have protective effects when administered simultaneously with these agents
Sensory peripheral neuropathy caused by administration of oxaliplatin is distinguished in 2 forms: (1) an acute peripheral sensory neuropathy that may appear during the administration of the drug or after the first few drug infusions and (2) a chronic dose-limiting cumulative peripheral sensory neuropathy
Summary
Platinum drugs are among the most important cytotoxic drugs available to oncologists. They share some structural similarities, there are marked differences in their therapeutic use, pharmacokinetics, and adverse effect profiles [1,2,3]. Cisplatin is the first agent of platinum drugs, which was approved in 1978 for the treatment of testicular and ovarian cancer [4]. Carboplatin is a second-generation platinum drug with equivalent activity, in some cancer types, to cisplatin. Carboplatin is often administered in combination with a taxane as a first-line treatment for ovarian cancer [5, 6]. This paper aims to highlight the neurotoxicity of commonly used platinum agents and published data on certain compounds that have been reported to have protective effects when administered simultaneously with these agents
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