Oxaliplatin neurotoxicity

Oxaliplatin (OXA) is a first-line agent in the systemic treatment of colorectal cancer (CRC). OXA-induced neuropathy is the most prominent adverse effect, both during and after the completion of chemotherapy. OXA neurotoxicity (OXA-NTX) is a dose-limiting, frequent, and long-lasting adverse event that may compromise therapeutic outcome and the quality-of-life of CRC patients. Increased knowledge of the pathophysiology and clinical profile of this neuropathy is being achieved. Two types of neuropathy are usually observed, and evidence suggests a link between the acute symptoms and the development of chronic NTX. In this paper we review the main advances and the outstanding issues concerning OXA-NTX, for example calcium/magnesium and other drugs in the prophylaxis and treatment of this neuropathy. Recently available and ongoing investigation of pharmacogenomics, clinical and neurophysiological risk factors, and early markers of OXA-NTX are of great value in clinical decision-making, contributing to minimizing the risk of severe neuropathy. © 2014 Springer Science+Business Media.