Platinum-induced peripheral neurotoxicity: From pathogenesis to treatment

Nathan P. Staff, Guido Cavaletti, Badrul Islam, Maryam Lustberg, Dimitri Psimaras, Stefano Tamburin

Research output: Contribution to journalReview article

Abstract

Platinum-induced peripheral neurotoxicity (PIPN) is a common side effect of platinum-based chemotherapy that may cause dose reduction and discontinuation, with oxaliplatin being more neurotoxic. PIPN includes acute neurotoxicity restricted to oxaliplatin, and chronic non-length-dependent sensory neuronopathy with positive and negative sensory symptoms and neuropathic pain in both upper and lower limbs. Chronic sensory axonal neuropathy manifesting as stocking-and-glove distribution is also frequent. Worsening of neuropathic symptoms after completing the last chemotherapy course may occur. Motor and autonomic involvement is uncommon. Ototoxicity is frequent in children and more commonly to cisplatin. Platinum-based compounds result in more prolonged neuropathic symptoms in comparison to other chemotherapy agents. Patient reported outcomes questionnaires, clinical evaluation and instrumental tools offer complementary information in PIPN. Electrodiagnostic features include diffusely reduced/abolished sensory action potentials, in keeping with a sensory neuronopathy. PIPN is dependent on cumulative dose but there is a large variability in its occurrence. The search for additional risk factors for PIPN has thus far yielded no consistent findings. There are currently no neuroprotective strategies to reduce the risk of PIPN, and symptomatic treatment is limited to duloxetine that was found effective in a single phase III intervention study. This review critically examines the pathogenesis, incidence, risk factors (both clinical and pharmacogenetic), clinical phenotype and management of PIPN.

Original languageEnglish (US)
Pages (from-to)S26-S39
JournalJournal of the Peripheral Nervous System
Volume24
Issue numberS2
DOIs
StatePublished - Oct 1 2019

Fingerprint

Platinum
oxaliplatin
Therapeutics
Drug Therapy
Platinum Compounds
Pharmacogenetics
Neuralgia
Cisplatin
Action Potentials
Lower Extremity
Phenotype
Incidence

Keywords

  • assessment
  • carboplatin
  • chemotherapy
  • cisplatin
  • diagnosis
  • neuropathy
  • neurotoxicity
  • oxaliplatin
  • prevention
  • treatment

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Platinum-induced peripheral neurotoxicity : From pathogenesis to treatment. / Staff, Nathan P.; Cavaletti, Guido; Islam, Badrul; Lustberg, Maryam; Psimaras, Dimitri; Tamburin, Stefano.

In: Journal of the Peripheral Nervous System, Vol. 24, No. S2, 01.10.2019, p. S26-S39.

Research output: Contribution to journalReview article

Staff, NP, Cavaletti, G, Islam, B, Lustberg, M, Psimaras, D & Tamburin, S 2019, 'Platinum-induced peripheral neurotoxicity: From pathogenesis to treatment', Journal of the Peripheral Nervous System, vol. 24, no. S2, pp. S26-S39. https://doi.org/10.1111/jns.12335
Staff, Nathan P. ; Cavaletti, Guido ; Islam, Badrul ; Lustberg, Maryam ; Psimaras, Dimitri ; Tamburin, Stefano. / Platinum-induced peripheral neurotoxicity : From pathogenesis to treatment. In: Journal of the Peripheral Nervous System. 2019 ; Vol. 24, No. S2. pp. S26-S39.
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