Chemotherapy: neurologic complications

Introduction
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By Eudocia Quant MD MPH, Jorg Dietrich MD PhD, and Patrick Y Wen MD

Patients with cancer are living longer due to earlier diagnoses and remarkable improvements in treatments. Unfortunately, neurologic complications from chemotherapy remain a significant cause of morbidity and may play a role in limiting potential treatments. In addition, novel therapies such as small molecule tyrosine kinase inhibitors and monoclonal antibodies have also been associated with neurologic complications. Because treatments for therapy-induced neurotoxicity are limited, awareness of common neurologic complications is important to prevent permanent damage. The authors review common neurologic complications of chemotherapy and novel systemic agents in this article. This article has been updated to include neurologic complications of newer targeted agents including ipilimumab.

Key points

  • Neurologic complications from chemotherapy impact quality of life and remain an important source of dose-limiting toxicity.
  • The neurotoxicities of chemotherapy are widely known, but several targeted agents such as bortezomib, ipilimumab, and bevacizumab are also associated with neurologic complications.
  • Early recognition and prevention may help avoid permanent neurologic damage.

In This Article

Introduction
Overview
Drugs that commonly cause neurotoxicity
Drugs that occasionally cause neurotoxicity
Drugs that rarely cause neurotoxicity
Hormonal therapy
Biological response modifiers
Growth factors
Monoclonal antibodies
Targeted molecular agents
Other agents
References cited
Contributors