Table 2

Chemotherapy drugs commonly associated with peripheral neuropathy

ClassDrugMalignancies commonly used inTypical clinical features of neuropathyAdditional features/notes
Platinum compoundsOxaliplatin*ColorectalPure sensory with ataxiaAcute paraesthesiae, cramps, fasciculation common after each dose
Cisplatin*Testicular, bladder, ovarian, cervical, lung, head and neckPure sensory with ataxiaCoasting common
can cause ototoxicity
TaxanesPaclitaxel*Breast, ovarian, pancreas, lungPredominantly sensory, often painfulAcute arthralgia and myalgia in 10%–30%
Docetaxel*Breast, prostate, lung, head and neck, gastricPredominantly sensory, often painfulAcute arthralgia and myalgia in 10%–30%
Vinca alkaloidsVincristine*Leukaemia, lymphomaDistal weakness and sensory symptomsAutonomic involvement common
Immunomodulatory agentsThalidomide*Multiple myelomaPredominantly sensory, sometimes painfulCramps may occur Constipation common
Proteasome inhibitorsBortezomib*Multiple myeloma, mantle cell lymphomaPainful, small-fibre predominant sensoryAutonomic involvement can occur and rarely non-length-dependent patterns
EpithilonesIxabepilone*Breast cancerPredominantly sensory, sometimes painfulNot used in UK outside clinical trial setting
Antibody–drug conjugatesBrentuximab vedotin*Hodgkin’s lymphoma, anaplastic and T-cell lymphomasPredominantly sensory with ataxia
Ado-trastuzumab emtansine†Breast (HER2 positive)Predominantly sensoryLimited clinical information in the literature
Immune checkpoint inhibitorsNivolumab, pembrolizumab, ipilimumab‡Melanoma, renal, lung, multiple othersAcute or subacute polyradiculoneuropathyUsually respond to corticosteroids
BRAF/MEK inhibitorsDabrafenib, vemurafenib, trametinib†Melanoma, non-small cell lung, thyroidLength-dependent sensory predominant, or acute/subacute polyradiculopathyMay 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).