Pharmacological Approaches and Natural Products for Prevention of Chemotherapy-Induced Peripheral Neuropathy - A Review

Marco Cascella,Maria Rosaria Muzio

doi:10.18052/www.scipress.com/ijppe.6.47

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) is a one of the most common and severe cancer treatment-related adverse effect. It can often cause the stop of the treatment and affects the long-term quality of life of cancer survivors, too. Unfortunately, there are no effective agent or protocol to prevent with strong evidence of effectiveness this toxicity prevention of CIPN. Thus, CIPN prevention mainly consists of cumulative dose-reduction or lower dose-intensities, especially in higher risk patients. After a brief description of pathophysiology and features of CIPN, the purpose of this study is to analyse the role of standard pharmacological approaches and natural products for prevention of this serious side effect.

Highlights

Chemotherapy-induced peripheral neuropathy (CIPN) is a one of the most common and severe cancer treatment-related adverse effect. It can often cause the stop of the treatment and affects the long-term quality of life of cancer survivors
A wide range of neurologic complications are associated with antineoplastic drug regimens, such as central neurotoxicity conditions, ranging from minor cognitive deficits to encephalopathy with dementia or even coma, and peripheral neurotoxicity
CIPN is generally a temporary manifestation, in a third of cases it represents a permanent side effect from the chemotherapy treatment employed and paresthesia and/or painful CIPN can persist from months to years after the end of the anticancer therapy [5]

Summary

Introduction

A wide range of neurologic complications are associated with antineoplastic drug regimens, such as central neurotoxicity conditions, ranging from minor cognitive deficits to encephalopathy with dementia or even coma, and peripheral neurotoxicity. Many chemotherapy drugs including platinum compounds, antitubulins (taxanes, vinca alkaloids, eribulin), proteasome inhibitors (bortezomib), immunomodulatory agents (thalidomide, lenalidomide, pomalidomide), and some of the newer biologics (alemtuzumab, ipilimumab, brentuximab) are known to cause peripheral nerve damage which is called chemotherapy-induced peripheral neuropathy (CIPN), [1, 2]. It is a common treatment-related adverse, affecting up to 48% of cancer patients who received chemotherapy [3] and worsening the long-term quality of life (QoL) of cancer survivors, too [4]. Because prevention seems to be the most effective way of dealing with CIPN, more investigations are directed at identifying any possible pharmacological strategy in both animal models and clinical trials, and this issue concerns alternative medicines

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