title: Chemotherapy-induced peripheral neuropathy in the adult.
abstract: OBJECTIVE
  This review focuses on the newest data on mechanistic aspects of chemotherapy-induced peripheral neuropathy (CIPN), its assessment and the current status of neuroprotection and treatment options.
  
  
  RESULTS
  Several anticancer drugs are associated with CIPN. Rodent models showed that axons, dorsal root ganglia and terminal trees are affected, whereas myelin remains unaffected. Oxidative stress and mitochondrial damage, as well as the role of nerve growth factor, have been highlighted in CIPN. Candidate genes, single nucleotide polymorphisms, were correlated with a higher incidence of CIPN in patients receiving a combination of chemotherapies. CIPN assessment mainly relies on patient-oriented questionnaires, nevertheless an international effort is ongoing to access reliable and objective means to assess small and large fiber impairment.To date, dose modification is the most effective strategy to prevent CIPN, whereas duloxetine is recommended for patients with painful CIPN.
  
  
  CONCLUSIONS
  CIPN is a common, potentially severe and dose-limiting adverse effect of cancer treatment. Chemotherapies mainly target axons, dorsal root ganglia and terminal trees of intraepidermal nerve fibers. A quick and noninvasive method allowing the assessment of CIPN should be developed, although no treatment prevents CIPN or improves its long-term course. Furthermore, symptomatic therapy is often largely ineffective in reducing CIPN symptoms.
authors.affiliation: aUMR 5782 MD4 Cognac-G, CNRS, Service de Santé des Armées, Université Paris-Descartes bService de Neurologie, Hôpital d'Instruction des Armées du Val-de-Grâce, Service de Santé des Armées cService de neurologie Mazarin, Groupe Hospitalo-Universitaire Pitié-Salpêtrière dEcole du Val-de-Grâce, Service de Santé des Armées, Paris, France *Mehdi Saad and Camille Tafani contributed equally to the writing of this article.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Saad
authors.forename: Camille
authors.initials: C
authors.lastname: Tafani
authors.forename: Dimitri
authors.initials: D
authors.lastname: Psimaras
authors.forename: Damien
authors.initials: D
authors.lastname: Ricard
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents