Table 1.

Specific toxicity profiles of neurotoxic chemotherapeutic agents, modified from [6, 17]

Cancer therapy		Increased risk of neurotoxicity	Incidence		Symptoms
Substance	Class		Grade 1–2*	Grade 3–4*
Cisplatin1,2	Platinum	> 300–350 mg/m2	14–63%	7–21%	• Predominantly sensory neuropathy • Painful paresthesia, numbness, tingling, impaired vibration sense, sensory ataxia
Oxaliplatin1,2,4,6	Platinum	> 550 mg/m2	18–100%	12–39%	• Acute sensory symptoms and chronic sensory neuropathy • Acute cold-induced paresthesia, cramps, fasciculations
Paclitaxel1,2,4	Taxane	> 250–300 mg/m2	20–50%	6–20%	• Predominantly sensory neuropathy • Painful paresthesia, numbness • Decreased vibration or proprioception • At higher doses, myalgia and myopathy
Docetaxel1,2,4		> 100 mg/m2
Vincristine1,2	Vinca alkaloid	> 2–6 mg/m2	35–45%		• Sensory neuropathy • Hypoesthesia (up to 100%), tingling paresthesia • Muscle cramps and mild distal weakness • Autonomic neuropathy
Thalidomide1,5	Immunomodulatory/antiangiogenic agent	> 20 g	≤ 83%	≤ 35%	• Sensory neuropathy • Muscle cramps and mild distal weakness
Bortezomib1,2,3	Proteasome inhibitor	> 16–26 mg/m2	≤ 50%	≤ 30%	• Painful, small-fiber sensory neuropathy • Painful paresthesia, burning sensation, sensory ataxia • Autonomic neuropathy including orthostatic hypotension
Eribulin	Microtubule inhibitor	n.a.	n.a.	n.a.	• Sensory neuropathy • Myalgia • Note: almost all patients are pretreated with (multiple) neurotoxic cancer therapies

¹Increased single doses are associated with greater neurotoxicity

²Increased cumulative doses are associated with greater neurotoxicity

³Dose threshold relationship, increasing risk until a plateau at 40 to 45 mg/m²

⁴Longer infusion duration may reduce neurotoxicity

⁵Longer duration of treatment increases the risk of neurotoxicity

⁶“Stop-and-go” regimens may be associated with lower neurotoxicity

*NCI-CTCAE scale