The Therapeutic Potential of Antioxidants in Chemotherapy-Induced Peripheral Neuropathy: Evidence from Preclinical and Clinical Studies

Neurotherapeutics. 2023 Mar;20(2):339-358. doi: 10.1007/s13311-023-01346-8. Epub 2023 Feb 3.

Abstract

As cancer therapies advance and patient survival improves, there has been growing concern about the long-term adverse effects that patients may experience following treatment, and concerns have been raised about such persistent, progressive, and often irreversible adverse effects. Chemotherapy is a potentially life-extending treatment, and chemotherapy-induced peripheral neuropathy (CIPN) is one of its most common long-term toxicities. At present, strategies for the prevention and treatment of CIPN are still an open problem faced by medicine, and there has been a large amount of previous evidence that oxidative damage is involved in the process of CIPN. In this review, we focus on the lines of defense involving antioxidants that exert the effect of inhibiting CIPN. We also provide an update on the targets and clinical prospects of different antioxidants (melatonin, N-acetylcysteine, vitamins, α-lipoic acid, mineral elements, phytochemicals, nutritional antioxidants, cytoprotectants and synthetic compounds) in the treatment of CIPN with the help of preclinical and clinical studies, emphasizing the great potential of antioxidants as adjuvant strategies to mitigate CIPN.

Keywords: Antinociceptive; Antioxidants; CIPN; Line of defense; Neurotoxicity; Reactive oxygen species.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcysteine / adverse effects
  • Antineoplastic Agents* / adverse effects
  • Antioxidants / therapeutic use
  • Humans
  • Oxidative Stress
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / drug therapy
  • Peripheral Nervous System Diseases* / prevention & control

Substances

  • Antineoplastic Agents
  • Antioxidants
  • Acetylcysteine