Class | Drug | Malignancies commonly used in | Typical clinical features of neuropathy | Additional features/notes |
Platinum compounds | Oxaliplatin* | Colorectal | Pure sensory with ataxia | Acute paraesthesiae, cramps, fasciculation common after each dose |
Cisplatin* | Testicular, bladder, ovarian, cervical, lung, head and neck | Pure sensory with ataxia | Coasting common can cause ototoxicity | |
Taxanes | Paclitaxel* | Breast, ovarian, pancreas, lung | Predominantly sensory, often painful | Acute arthralgia and myalgia in 10%–30% |
Docetaxel* | Breast, prostate, lung, head and neck, gastric | Predominantly sensory, often painful | Acute arthralgia and myalgia in 10%–30% | |
Vinca alkaloids | Vincristine* | Leukaemia, lymphoma | Distal weakness and sensory symptoms | Autonomic involvement common |
Immunomodulatory agents | Thalidomide* | Multiple myeloma | Predominantly sensory, sometimes painful | Cramps may occur Constipation common |
Proteasome inhibitors | Bortezomib* | Multiple myeloma, mantle cell lymphoma | Painful, small-fibre predominant sensory | Autonomic involvement can occur and rarely non-length-dependent patterns |
Epithilones | Ixabepilone* | Breast cancer | Predominantly sensory, sometimes painful | Not used in UK outside clinical trial setting |
Antibody–drug conjugates | Brentuximab vedotin* | Hodgkin’s lymphoma, anaplastic and T-cell lymphomas | Predominantly sensory with ataxia | |
Ado-trastuzumab emtansine† | Breast (HER2 positive) | Predominantly sensory | Limited clinical information in the literature | |
Immune checkpoint inhibitors | Nivolumab, pembrolizumab, ipilimumab‡ | Melanoma, renal, lung, multiple others | Acute or subacute polyradiculoneuropathy | Usually respond to corticosteroids |
BRAF/MEK inhibitors | Dabrafenib, vemurafenib, trametinib† | Melanoma, non-small cell lung, thyroid | Length-dependent sensory predominant, or acute/subacute polyradiculopathy | May respond to immunotherapy |
*Neuropathy is dose related (more likely with increasing cumulative dose).
†Relationship to dose is unclear/not reported.
‡Neuropathy is likely to be idiosyncratic and unrelated to dose.
MEK, mitogen-activated protein kinase kinase (or MAP2K).