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. 2024 Oct 25;20(6):551–562. doi: 10.3988/jcn.2024.0221

Table 2. Chemotherapeutic agents and their mechanisms contributing to autonomic neuropathy.

Anticancer drugs Possible mechanisms underlying autonomic neuropathy
Taxanes (docetaxel, paclitaxel) Microtubule injury, mitochondrial damage, inflammatory cytokines, oxidative stress, direct axonal damage, voltage-gated-ion-channel dysfunction
Vinca alkaloids (vinblastine, vincristine) Microtubule injury
Platinum-based agents (cisplatin, carboplatin, oxaliplatin) Mitochondrial damage, inflammatory cytokines, oxidative stress, voltage-gated-ion-channel dysfunction, parasympathetic dysfunction
Proteasome inhibitors (bortezomib) Sphingolipid dysregulation, neuroinflammatory signaling pathway activation, mitochondrial damage, inflammatory cytokines, oxidative stress
Immune checkpoint inhibitors (ipilimumab, nivolumab, pembrolizumab) Possible autoimmunity