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Expert Review of Anticancer Therapy Nov 2017Chemotherapy-induced peripheral neuropathy (CIPN), a common adverse effect of several chemotherapeutic agents, has a significant impact on quality of life and may even... (Review)
Review
Chemotherapy-induced peripheral neuropathy (CIPN), a common adverse effect of several chemotherapeutic agents, has a significant impact on quality of life and may even compromise treatment efficacy, requiring chemotherapy dose reduction or discontinuation. CIPN is predominantly related with sensory rather than motor symptoms and the most common related cytotoxic agents are platinum compounds, taxanes and vinca alkaloids. CIPN symptoms may resolve after treatment cessation, but they can also be permanent and continue for years. Areas covered: We present an overview of CIPN pathophysiology, clinical assessment, prevention and treatment identified through a Pubmed search. Expert commentary: No substantial progress has been made in the last few years within the field of prevention and/or treatment of CIPN, in spite of remarkable efforts. Continuous research could expand our knowledge about chemotherapeutic-specific neuropathic pathways and eventually lead to the conception of innovative and targeted agents for the prevention and/or treatment of this debilitating chemotherapy adverse effect.
Topics: Animals; Antineoplastic Agents; Dose-Response Relationship, Drug; Drug Design; Humans; Molecular Targeted Therapy; Peripheral Nervous System Diseases; Quality of Life
PubMed: 28868935
DOI: 10.1080/14737140.2017.1374856 -
Clinics in Plastic Surgery Oct 2017Peripheral neuropathy and nerve compression syndromes lead to substantial morbidity following burn injury. Patients present with pain, paresthesias, or weakness along a... (Review)
Review
Peripheral neuropathy and nerve compression syndromes lead to substantial morbidity following burn injury. Patients present with pain, paresthesias, or weakness along a specific nerve distribution or experience generalized peripheral neuropathy. The symptoms manifest at various times from within one week of hospitalization to many months after wound closure. Peripheral neuropathy may be caused by vascular occlusion of vasa nervorum, inflammation, neurotoxin production leading to apoptosis, and direct destruction of nerves from the burn injury. This article discusses the natural history, diagnosis, current treatments, and future directions for potential interventions for peripheral neuropathy and nerve compression syndromes related to burn injury.
Topics: Analgesics, Opioid; Burns; Humans; Nerve Compression Syndromes; Pain; Peripheral Nervous System Diseases
PubMed: 28888304
DOI: 10.1016/j.cps.2017.05.010 -
Seminars in Oncology Nursing Feb 2020To review assessment and management approaches for chemotherapy-induced peripheral neuropathy-related physical function deficits. (Review)
Review
OBJECTIVE
To review assessment and management approaches for chemotherapy-induced peripheral neuropathy-related physical function deficits.
DATA SOURCES
Peer-reviewed articles from PubMed, Ovid MEDLINE, CINAHL PsycINFO, SPORTDiscus, Scopus, and key studies' reference lists.
CONCLUSION
Brief clinical tests (eg, gait, Timed Up and Go) can screen for neuropathy-related physical function deficits. Exercise and physical therapy may be promising treatments, but the efficacy and optimal dose of such treatments for chemotherapy-induced peripheral neuropathy are unclear.
IMPLICATIONS FOR NURSING PRACTICE
Screening and assessment of neuropathy-associated physical function deficits should occur throughout neurotoxic chemotherapy treatment. If such deficits are identified, referral for rehabilitation (ie, physical or occupational therapy) and/or exercise interventions is warranted.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Oncology Nursing; Peripheral Nervous System Diseases; Physical Therapy Modalities; Practice Guidelines as Topic; Rehabilitation Nursing
PubMed: 31959510
DOI: 10.1016/j.soncn.2019.150983 -
Neuroscience Letters Jun 2015Peripheral neuropathy can lead to neuropathic pain in a subset of patients. Painful peripheral neuropathy is a debilitating disorder, reflected by a reduced quality of... (Review)
Review
Peripheral neuropathy can lead to neuropathic pain in a subset of patients. Painful peripheral neuropathy is a debilitating disorder, reflected by a reduced quality of life. Therapeutic strategies are limited and often disappointing, as in most cases targeted treatment is not available. Elucidating pathogenetic factors for pain might provide a target for optimal treatment. Voltage-gated sodium channels NaV1.7-NaV1.9 are expressed in the small-diameter dorsal root ganglion neurons and their axons. By a targeted gene approach, missense gain-of-function mutations of NaV1.7-NaV1.9 have been demonstrated in painful peripheral neuropathy. Functional analyses have shown that these mutations produce a spectrum of pro-excitatory changes in channel biophysics, with the shared outcome at the cellular level of dorsal root ganglion hyperexcitability. Reduced neurite outgrowth may be another consequence of sodium channel mutations, and possible therapeutic strategies include blockade of sodium channels or block of reverse operation of the sodium-calcium exchanger. Increased understanding of the pathophysiology of painful peripheral neuropathy offers new targets that may provide a basis for more effective treatment.
Topics: Axons; Ganglia, Spinal; Humans; Mutation; Neuralgia; Neurons; Peripheral Nervous System Diseases; Voltage-Gated Sodium Channels
PubMed: 25556685
DOI: 10.1016/j.neulet.2014.12.056 -
Physical Medicine and Rehabilitation... Nov 2018Cancer treatments continue to advance the management and survival of patients. However, use of these regimens can lead to significant side effects both temporary and... (Review)
Review
Cancer treatments continue to advance the management and survival of patients. However, use of these regimens can lead to significant side effects both temporary and permanent. Neuromuscular side effects include chemotherapy-induced peripheral neuropathy and radiation fibrosis syndrome. At this time, the only way to resolve the neurotoxicity is reduction or discontinuation of the offending agent. In an attempt to limit interference with a patient's chemotherapy regimen and mitigate chronic disability, efforts for early detection through subjective clinical evaluations and objective measurement with electrodiagnostics can help to improve symptom management and minimize alteration in treatment.
Topics: Animals; Antineoplastic Agents; Electrodiagnosis; Humans; Neoplasms; Neurotoxicity Syndromes; Peripheral Nervous System Diseases; Radiation Injuries; Risk
PubMed: 30293625
DOI: 10.1016/j.pmr.2018.06.006 -
Ginekologia Polska 2016Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most important neurologic complications experienced by patients receiving chemotherapy. The neuropathy... (Review)
Review
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most important neurologic complications experienced by patients receiving chemotherapy. The neuropathy often interferes with daily activities and exercise leading to severe impairment of the patient's quality of life (QoL). The evolution of most CIPNs is characterized by a gradual onset of signs/symptoms, beginning in the lower limbs and advancing proximally into a bilateral stocking and glove distribution. Patients often complain of numbness, tingling and pain in the affected areas. The symptoms become aggravated with repeated cycles of chemotherapy. When the offending agent is withheld, the symptoms generally abate, but relief is not guaranteed. The consequences of delay or discontinuation of treatment may affect overall patient survival.
Topics: Antineoplastic Agents; Female; Humans; Paresthesia; Peripheral Nervous System Diseases; Risk Factors
PubMed: 27321102
DOI: 10.17772/gp/61750 -
Anticancer Research Oct 2022Chemotherapy-induced peripheral neuropathy (CIPN) develops as a challenging nerve-damaging adverse effect of anticancer drugs used in chemotherapy. The disorder may... (Review)
Review
Chemotherapy-induced peripheral neuropathy (CIPN) develops as a challenging nerve-damaging adverse effect of anticancer drugs used in chemotherapy. The disorder may require a chemotherapy dose reduction and a cessation of administration of chemotherapeutic drugs. Its principal sensory symptoms include, tingling, and numbness in the hands and feet. Severe pain can be encompassed among clinical manifestations. CIPN affects dramatically the patient's quality of life (QoL). Pain and sensory symptoms may occur for months, or even years after the termination of chemotherapeutic drugs. Although many pharmacological and non-pharmacological therapeutic approaches have been tested to overcome these symptoms, there is currently no standardized treatment for CIPN. According to current guidelines, Duloxetine is the only recommended agent for painful neuropathic symptoms. Therefore, finding effective therapies for CIPN is mandatory. The aim of this review was to dissect CIPN, the target and immunotherapy-based approaches to this disorder, as well as to offer new insights for new therapeutic perspectives.
Topics: Antineoplastic Agents; Duloxetine Hydrochloride; Humans; Pain; Peripheral Nervous System Diseases; Quality of Life
PubMed: 36191965
DOI: 10.21873/anticanres.15971 -
Continuum (Minneapolis, Minn.) Jun 2020This article describes the neurologic manifestations of systemic autoimmune diseases. (Review)
Review
PURPOSE
This article describes the neurologic manifestations of systemic autoimmune diseases.
RECENT FINDINGS
Systemic autoimmune diseases can be associated with a wide spectrum of neurologic comorbidities involving the central and peripheral nervous systems. Systemic lupus erythematosus (SLE) can be associated with a number of manifestations predominantly affecting the central nervous system (CNS), whereas peripheral neuropathy is less common. Sjögren syndrome can be associated with peripheral neuropathy in 10% of cases and CNS disease in 2% to 5% of cases. The risk of stroke is increased in SLE, rheumatoid arthritis, temporal arteritis, psoriatic arthritis, and ankylosing spondylitis. Systemic vasculitides present most commonly with mononeuritis multiplex but can also affect the CNS. Cognitive dysfunction is a common symptom among patients with systemic autoimmune diseases, most commonly seen in patients with SLE or Sjögren syndrome.
SUMMARY
Neurologic manifestations of systemic autoimmune disease are important to recognize, as they may often be the presenting manifestation leading to diagnosis of the systemic disease or may be associated with increased morbidity, other complications, or mortality. Timely diagnosis and institution of appropriate treatment, often requiring multidisciplinary care, is essential to minimize morbidity and decrease the risk of permanent neurologic deficits.
Topics: Autoimmune Diseases; Central Nervous System Diseases; Humans; Peripheral Nervous System Diseases; Rheumatic Diseases
PubMed: 32487898
DOI: 10.1212/CON.0000000000000856 -
Clinical Journal of Oncology Nursing Dec 2021For peripheral neuropathy, standards of care are based on established evidence-based practice. Peripheral neuropathy is disease or dysfunction of one or more...
For peripheral neuropathy, standards of care are based on established evidence-based practice. Peripheral neuropathy is disease or dysfunction of one or more peripheral nerves (i.e., motor, sensory, or autonomic), resulting in numbness or weakness. Peripheral neuropathy occurs outside of the brain and spinal cord and is caused by cancer, treatment, or both. Chemotherapeutic agents that can cause peripheral neuropathy include epothilones, platinum analogs, taxanes, and vinca alkaloids, as well as immunomodulating drugs and proteasome inhibitors.
Topics: Antineoplastic Agents; Drug-Related Side Effects and Adverse Reactions; Humans; Neoplasms; Peripheral Nervous System Diseases; Taxoids
PubMed: 34800128
DOI: 10.1188/21.CJON.S2.30 -
Current Neurology and Neuroscience... Jun 2017The purpose of this study was to briefly discuss chemotherapy-induced peripheral neuropathy (CIPN) and detail the most important and most recent chemotherapeutic agents... (Review)
Review
PURPOSE OF REVIEW
The purpose of this study was to briefly discuss chemotherapy-induced peripheral neuropathy (CIPN) and detail the most important and most recent chemotherapeutic agents implicated. This review will examine neuropathy mechanisms, risk factors, and clinical patterns; novel and prospective drugs with similar effects that are less well known to neurologists are discussed.
RECENT FINDINGS
CIPN is increasingly recognized for its clinical importance and effect on patient quality of life. Identification of risk factors is ongoing and may enable future risk stratification. Newer classes of agents and new members of existing classes are continually recognized, notably immune check point inhibitors, other monoclonal antibody treatments, novel immunomodulatory agents, and proteasome inhibitors. Advances regarding established classes including taxanes, platins, and vinca alkaloids are also reviewed. CIPN is an important often dose-limiting toxicity. Multiple agents cause neuropathy; various clinical patterns are described. Future studies should aim at improved understanding of toxicity mechanisms and development of preventive and therapeutic strategies.
Topics: Antineoplastic Agents; Humans; Peripheral Nervous System Diseases; Quality of Life; Risk Factors
PubMed: 28421360
DOI: 10.1007/s11910-017-0757-7