Chemotherapy neurotoxicity: pharmacological and toxicological aspects

Objective: The purpose of this article is, starting from pharmacological aspects, to evaluate the central and peripheral neurotoxicity of some chemotherapy compounds and also some possible neuroprotection strategies. Methods: both personal knowledge of pharmacology and the use of both paper books and international website databases such as pubmed, scopus, google scholar, researchgate were used to develop the article, typing in keywords such as "chemotherapy neurotoxicity" or "neurotoxicity" associated with specific compound names. Results: Chemotherapy-induced neurological complications, while overall rare and non-fatal, can be disabling and even lead to serious difficulties in grasping and manipulating objects or the inability to perform the most common daily gestures. The duration of these symptoms, although usually regressing in part between one treatment cycle and the next, is cumulative and, sometimes, the limiting factor for the tolerability of the therapy itself. Due to neuropathy, therapy must necessarily be reshaped or even stopped. Conclusions: chemotherapy-induced iatrogenic neuropathies remain rare overall, around 10-15% of treated subjects, but can be disabling. Early treatment and neuroprotection strategies are essential, such as supplementation with antioxidant and lipophilic substances such as vitamin derivatives or the use of systems to better convey the drug in tumor tissues, reducing systemic exposure and their side effects.