Table 2.

Commonly used anticancer agents associated with chemotherapy-induced peripheral neuropathy (CIPN) ^4–11,13

Class	Agents	Proposed Mechanism	Clinical Symptoms	Main Target of CIPN Toxicity
Taxanes	Paclitaxel Docetaxel Ixabepilone	Microtubule disruption	Symmetrical painful paresthesias or numbness in a stocking-glove distribution, sensory loss, motor symptoms at high dose	Dorsal root ganglion; axons; distal nerve terminals
Platinum-based	Cisplatin Carboplatin Oxaliplatin	DNA adducts	Symmetrical painful paresthesias or numbness in a stocking-glove distribution; Early: cold allodynia and hyperalgesia; Later: loss of motor function; Long-term chronic sensory neuropathy	Dorsal root ganglion
Alkylating agents	Cyclophosphamide Hexamethylmelamine Ifosphamide Procarbazine	Covalently bind to DNA	Spectrum ranging from numbness and paresthesias to pain	Dorsal root ganglion
Vinca alkaloids	Vincristine Vinblastine Vinorelbine Vindesine	Dysfunction of mitochondria and endoplasmic reticulum; microtubule disruption	Symmetrical sensorimotor painful neuropathy: tingling paresthesias, proprioceptive loss, areflexia, and ataxia; Constipation; Muscle weakness; Gait dysfunction	Dorsal root ganglion; distal nerve terminals
Proteosome inhibitors	Bortezomib Carfilzomib Ixazomib	Binds proteasome complex; mitochondrial disturbance; microtubule disruption	Sensory painful neuropathy	Dorsal root ganglion and peripheral nerves
Immunomodulatory	Thalidomide Lenalidomide Pomalidomide	Antiangiogenesis	Symmetrical distal paresthesias, dysesthesias; Sensory painful neuropathy; Muscle cramps	Dorsal root ganglion; distal nerve terminals