Oxaliplatin-induced peripheral neuropathy: clinical features, mechanisms, prevention and treatment

J Neurol. 2021 Sep;268(9):3269-3282. doi: 10.1007/s00415-020-09942-w. Epub 2020 May 30.

Abstract

Oxaliplatin (OXA) is a commonly used platinum-based chemotherapy drug for colorectal cancer. OXA-induced peripheral neurotoxcity (OIPN) is a comprehensive adverse reaction of OXA. OIPN can be divided into acute and chronic types according to clinical features and different mechanisms. The main clinical features of acute OIPN are cold-sensitive sensory symptoms and neuropathic pain in limbs. In addition to the above symptoms, chronic OIPN also produces autonomic nerve dysfunction. The most important mechanism involved in acute OIPN is the alteration of voltage-gated Na + channels, and nuclear DNA damage in chronic OIPN. There are some methods like reducing exposure to cold, calcium and magnesium salts, amifostine could be beneficial in acute OIPN prevention and dose modification, changing in schedule glutathione, duloxetine, selective serotonin reuptake inhibitors, carbonic anhydrase inhibitor in chronic OIPN prevention. Recent updates are provided in this article in relation to the clinical features, potential mechanisms, prevention and treatment of OIPN.

Keywords: Clinical features; Neuropathy; Oxaliplatin; Prevention and treatment.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Humans
  • Oxaliplatin / adverse effects
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / drug therapy
  • Peripheral Nervous System Diseases* / prevention & control

Substances

  • Antineoplastic Agents
  • Oxaliplatin