Chemotherapy-Induced Peripheral Neuropathy: Mechanisms and Therapeutic Avenues

Neurotherapeutics. 2021 Oct;18(4):2384-2396. doi: 10.1007/s13311-021-01142-2. Epub 2021 Oct 21.


Chemotherapy-induced peripheral neuropathy (CIPN) is a serious and often persistent adverse consequence of certain chemotherapeutic agents. It is a major dose-limiting factor of many first-line chemotherapies, affecting 20-50% of patients at standard doses and nearly all patients at high doses. As cancer survivorship continues to increase with improvements in early diagnosis and treatment, more patients will experience CIPN despite completing cancer treatment, which interferes with recovery, leading to chronic pain and worsening quality of life. The National Cancer Institute has identified CIPN as a priority in translational research. To date, there are no FDA-approved drugs for preventing or treating CIPN, with emerging debate on mechanisms and promising new targets. This review highlights current literature and suggests novel approaches to CIPN based on proposed mechanisms of action that aim either to confer neuroprotection against chemotherapy-induced neurotoxicity or reverse the downstream effects of painful neuropathy.

Keywords: Antinociceptive; Chemotherapy-induced peripheral neuropathy; Mechanisms; Neuroprotective; Treatment.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Humans
  • Pain / drug therapy
  • Peripheral Nervous System Diseases* / drug therapy
  • Peripheral Nervous System Diseases* / therapy
  • Quality of Life


  • Antineoplastic Agents