Systemic anti-cancer therapy associated with the occurrence of peripheral neurotoxicity and, specifically, peripheral neuropathy.

The investigation of peripheral neurotoxicity associated with systemic anticancer therapy (SACT) agents is often confined to a small range of chemotherapy agents. This study aimed to identify all SACT agents associated with peripheral neurotoxicity and, specifically, peripheral neuropathy, and to provide incidence estimates for the development of each type of neurotoxicity associated with each agent. Antineoplastic agents approved globally for clinical and/or research purposes were identified through triangulation of nine national and global drug product databases. The class of each agent was identified using DrugBank Online. Evidence of peripheral neurotoxicity and, specifically, peripheral neuropathy was obtained by reviewing Micromedex (and, where required, supplemented by data reported in national clinical trials registries). A total of 467 approved antineoplastic agents were identified for clinical and/or research purposes globally. Peripheral neurotoxicity (including neuropathy) was associated with 144 (31%) agents: 49 (45%) classical chemotherapeutic agents; 61 (21%) targeted therapies; 26 (63%) immunotherapies; and 8 (25%) hormone therapies. Peripheral neuropathy, specifically, was associated with 77 (16%) agents: 30 (27%) classical chemotherapeutic agents; 31 (11%) targeted therapies; 16 (39%) immunotherapies; and no hormone therapies. Based on the currently available evidence, this inventory of neurotoxic SACT agents could be considered exhaustive. From clinical and research perspectives, a comprehensive inventory of neurotoxic SACT agents is pivotal to informing drug design and understanding and implementing appropriate drug choice, as well as investigating the mechanisms involved in the neurotoxic effects of agents and identifying neuroprotective strategies for patients undergoing SACT.