Neurotoxic complications of cancer chemotherapy

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Abstract

Introduction. Neurotoxicity is a common complication of chemotherapy that negatively affects the quality of life of cancer patients. Damage to the nervous system affects both the peripheral nerves (peripheral neuropathy) and the central nervous system (chemo brain), manifesting itself as cognitive impairment.

The main of the review. Аnalysis and generalization of key aspects of chemotherapy neurotoxicity, including pathogenetic mechanisms of damage to the nervous system, characteristics of the most significant neurotoxic drugs and risk factors for these complications.

Material and methods. The review includes studies published between 2005 and 2024. The search for publications was conducted in the PubMed, Scopus, Web of Science, eLibrary, Cochrane Library, Springer, CyberLeninka, Wiley Online Library, Nature, ScienceDirect, Science, Cell, Frontiers databases using the main keywords. A total of 1240 articles were found, 63 sources were used for citation.

Results. The article reviews current data on the incidence of peripheral neuropathy in cancer patients (68%) and its long-term persistence in one third of patients. The main mechanisms of neurotoxicity (mitochondrial damage, impaired axonal transport, cytoskeletal dysfunction, activation of inflammatory and autoimmune reactions) are discussed. The causes of central neurotoxicity (impaired neurogenesis, neuronal DNA damage, glial activation, chronic neuroinflammation, and white matter demyelination) are highlighted. The key groups of neurotoxic drugs (platinum compounds, taxanes, vinca alkaloids, proteasome inhibitors, immunomodulators) and significant risk factors for neurotoxicity (old age, underlying neuropathy, diabetes mellitus, nutritional deficiency, chronic diseases, and genetic predisposition) are highlighted.

Conclusion. Despite progress in understanding the pathogenesis, effective methods for preventing and treating neurotoxic complications are limited, and reliable prognostic biomarkers have not been identified. Further interdisciplinary research into the mechanisms of nervous system damage and the development of personalized patient management strategies that optimize the effectiveness of antitumor therapy while minimizing neurological complications are needed.

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About the authors

Lydia Semenovna Evert

Federal Research Center «Krasnoyarsk Scientific Center of the Siberian Branch of the Russian Academy of Sciences»; Khakass State University named after N.F. Katanov of the Ministry of Science and Higher Education of the Russian Federation

Email: lidiya_evert@mail.ru
ORCID iD: 0000-0003-0665-7428

Chief Researcher, Clinical Department of Somatic and Mental Health of Children, a separate unit – Research Institute of Medical Problems of the North, Professor of the Department of General Professional Disciplines, Medical Institute, Doctor of Medical Sciences

Russian Federation, Partizan Zheleznyak str., 3G, Krasnoyarsk, 660022; Lenin Avenue, 90, Abakan, 655017

Tatyana Vitalievna Potupchik

Federal State Budgetary Educational Institution of Higher Education «Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky» of the Ministry of Health of the Russian Federation

Email: potupchik_tatyana@mail.ru
ORCID iD: 0000-0003-1133-4447

Associate Professor, Department of Pharmacology and Clinical Pharmacology with a postgraduate course, Candidate of Medical Sciences

Russian Federation, Partizan Zheleznyak str., 1, Krasnoyarsk, 660022

Yulia Vladimirovna Saranchina

Khakass State University named after N.F. Katanov of the Ministry of Science and Higher Education of the Russian Federation

Author for correspondence.
Email: july.saran4ina2010@yandex.ru
ORCID iD: 0000-0002-2697-7317

Associate Professor of the Department of Fundamental Medicine, Medical Institute, Candidate of Biological Sciences

Russian Federation, Lenin Avenue, 90, Abakan, 655017

Madina Kureishevna Khadzieva

Federal State Autonomous Educational Institution of Higher Education «N.I. Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation

Email: beki.gi@bk.ru
ORCID iD: 0009-0004-4207-016X

5thyear student

Russian Federation, Ostrovityanova str., 1, building 6, Moscow, 117513

Varvara Sergeevna Samoyavcheva

Federal State Autonomous Educational Institution of Higher Education «N.I. Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation

Email: samoyavvarvara@gmail.com
ORCID iD: 0009-0004-0819-4206

5thyear student

Russian Federation, Ostrovityanova str., 1, building 6, Moscow, 117513

Rufina Ramil’evna Tsalikova

Federal State Autonomous Educational Institution of Higher Education «N.I. Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian Federation

Email: traffic88@list.ru
ORCID iD: 0009-0007-4005-2322

5thyear student

Russian Federation, Ostrovityanova str., 1, building 6, Moscow, 117513

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