Chemotherapy-Induced Peripheral Neurotoxicity (CIPN)

The use of very effective anticancer drugs has allowed to remarkably improving the course of several solid and haematological tumours. However, the use of these agents is frequently associated with severe side effects, and among these off-target toxicities Chemotherapy-Induced Peripheral Neurotoxicity (CIPN) is emerging as a relevant dose-limiting factor. CIPN is associated to the use of anticancer agents such as platinum drugs, taxanes, and epothilones, which are part of the treatment plan of highly frequent solid tumours including lung, breast and gastrointestinal malignancies. However, thalidomide, vinca alkaloids and proteasome inhibitors, which are largely used in the treatment of haematological tumours, are also neurotoxic. Moreover, peripheral neurotoxicity is also associated with the use of newer treatments, such as those based on the administration of conjugated monoclonal antibodies, small molecule inhibitors, immune checkpoint inhibitors, and on chimeric antigen receptor T cell therapy. The knowledge of the mechanisms at the basis of CIPN is still limited, and no effective prevention or treatment therapies are available.