Abstract
Oxaliplatin-induced peripheral neuropathy (OXAIPN) is of great clinical interest as it ranks among the most common dose limiting toxicities of oxaliplatin (OXA) administration with an obvious impact on the outcome of cancer patients. In addition, OXAIPN has a detrimental effect on the quality of life of cancer patients because it can be long lasting or even permanent. It has a unique spectrum of clinical presentation, being manifested with two distinct syndromes: the acute neurotoxicity that appears soon after OXA administration and is usually transient, and the chronic cumulative syndrome that resembles the characteristics of all platinum compounds. Despite advances in research in relation to the elucidation of the true OXAIPN pathogenesis, characteristics and management, there are still several open issues to be addressed. One of the most important open issues is to determine reliable biomarkers to allow prompt identification of patients at high risk to develop OXAIPN and towards this view well designed genome wide analyses are warranted to adequately address this gap in knowledge. Recent updates are provided in this article in relation to the pathogenesis, clinical characteristics, pharmacogenetics and management of OXAIPN.
Highlights
Recent advances in the treatment of cancer with antineoplastic agents have significantly increased the survival rates of patients
OXA acts by blocking DNA replication and transcription, causing cell death and is typically administered with 5-fluorouracil (5-FU) and leucovorin in a combination regimen, known as FOLFOX, or in combination with capecitabine orally administered in a combination regimen, known as XELOX
As concerns the chronic clinical form that closely resembles the characteristics of cisplatin-induced peripheral neurotoxicity [5], it is acknowledged that the dorsal root ganglia (DRG) of the primary sensory neurons are the most common neuronal target of OXA [2]
Summary
Recent advances in the treatment of cancer with antineoplastic agents have significantly increased the survival rates of patients. Oxaliplatin-induced peripheral neurotoxicity (OXAIPN), in the form of the acute and chronic clinical syndrome, ranks among the most frequent non-hematological toxicity secondary to the use of OXA-based treatment [2]. It is considered as being the major dose limiting factor, second to hematological toxicities with an obvious impact on the outcome of cancer patients in case of changes in the treatment plan [3]. It can be detrimental to the quality of life (QOL) of cancer survivors, because it can be long-lasting or even permanent [4] It is provided recent updates in relation to the pathogenesis, clinical characteristics, pharmacogenetics and management of OXAIPN
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