Neuropathy associated with microtubule inhibitors

Diagnosis, incidence, and management

Sandra M. Swain, Joseph C. Arezzo

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

Microtubule inhibitor (MTI)-based chemotherapies used in the treatment of breast cancer - including vinca alkaloids, taxanes, and epothilones - are known to be associated with peripheral neuropathy. The incidence and severity of neuropathy, most frequently sensory in nature, depend on the agent used, absolute and cumulative drug dose, administration schedule, and presence of comorbidities. Although some first-generation vinca alkaloids, such as vincristine, were associated with severe mixed sensory/motor neuropathy, the deficits associated with newer agents in this class (eg, vinflunine) are generally milder and limited to distal sensory signs and symptoms. Among the taxanes, sensory neuropathy is reported more often with administration of paclitaxel and albumin-bound paclitaxel and less frequently with docetaxel. Epothilones, a new class of MTI, may be associated with grade 3/4 peripheral neuropathy; however, the neuropathy associated with ixabepilone, a novel epothilone B analog, is generally mild to moderate and reversible to baseline or grade 1 level. The neuropathy induced by MTI therapy is best managed with dose adjustments and/or treatment delay. This article provides an overview of the incidence, characteristics, and management of MTI-associated neurotoxicities for known vinca alkaloids and taxanes, as well as newer agents, such as vinflunine and ixabepilone.

Original languageEnglish (US)
Pages (from-to)455-457
Number of pages3
JournalClinical Advances in Hematology and Oncology
Volume6
Issue number6
StatePublished - Jun 2008

Fingerprint

Vinca Alkaloids
Microtubules
Taxoids
Epothilones
Incidence
docetaxel
Peripheral Nervous System Diseases
Drug Administration Schedule
Vincristine
Paclitaxel
Signs and Symptoms
Comorbidity
Therapeutics
Breast Neoplasms
Drug Therapy
ixabepilone
vinflunine

Keywords

  • Epothilone
  • Ixabepilone
  • Microtubule inhibitor
  • Sensory neuropathy
  • Taxane
  • Vinca alkaloid

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Neuropathy associated with microtubule inhibitors : Diagnosis, incidence, and management. / Swain, Sandra M.; Arezzo, Joseph C.

In: Clinical Advances in Hematology and Oncology, Vol. 6, No. 6, 06.2008, p. 455-457.

Research output: Contribution to journalArticle

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