Platinum-drugs induced peripheral neurotoxicity: clinical course and preclinical evidence

ABSTRACT

Introduction: Platinum-drugs (Cisplatin, Carboplatin, Oxaliplatin) are widely used in Medical Oncology departments to treat common neoplasms whose survival has greatly increased in the last few years. Thus, there is a growing population of cancer survivors who were treated with them and whose Quality of Life can be impaired by neurological late toxicities.

Areas covered: Essential clinical information of natural history, predisposing factors, assessment issues and lacks in treatment for peripheral neurotoxicity are here reported. An overview of preclinical pathogenetic observations is also given to drive future drug discovery.

Expert opinion: To unravel needs and lacks for platinum-induced neurotoxicity a great effort is still to be done. A coordinated and combined effort of clinical and preclinical researchers is required. The newborn multidisciplinary Toxic Neuropathy Consortium – Special Interest Group of the Peripheral Nerve Society – seems a virtuous alliance that might find answers to meet clinical and scientific needs in this field.

KEYWORDS:

• Platinum-drugs
• peripheral neurotoxicity
• animal models
• translational medicine
• Quality of Life
• cancer survivors

Article highlights

• Platinum-drugs are widely used and there is a growing population of cancer survivors who were treated with them.

• Peripheral neurotoxicity is one of the main dose-limiting toxicities of these drugs. This condition can be long-lasting or even permanent.

• No treatment is available to prevent/contrast this adverse event.

• The main reason for this unmet clinical need is a difficulty in designing solid clinical trials due to the lack of a gold standard outcome measure and an uncomplete pathogenetic knowledge.

• In the next few years, both ‘bed-side’ and ‘bench-side’ should virtuously cooperate to push further knowledge in this field in order to find a cure for this detrimental long-term toxicity.

This box summarizes key points contained in the article.

Acknowledgments

Dr. Alice Strambini’s linguistic revision is thankfully acknowledged.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.