Bortezomib-induced peripheral neuropathy: Clinical features, molecular basis, and therapeutic approach
Yang Yang, Bing Zhao, Hongli Lan, Jinbing Sun, Guoli Wei
Abstract
Bortezomib is the first-line standard and most effective chemotherapeutic for multiple myeloma; however, bortezomib-induced peripheral neuropathy (BIPN) severely affects the chemotherapy regimen and has long-term impact on patients under maintenance therapy. The pathogenesis of BIPN is poorly understood, and basic research and development of BIPN management drugs are in early stages. Besides chemotherapy dose reduction and regimen modification, no recommended prevention and treatment approaches are available for BIPN apart from the International Myeloma Working Group guidelines for peripheral neuropathy in myeloma. An in-depth exploration of the pathogenesis of BIPN, development of additional therapeutic approaches, and identification of risk factors are needed. Optimizing effective and standardized BIPN treatment plans and providing more decision-making evidence for clinical diagnosis and treatment of BIPN are necessary. This article reviews the recent advances in BIPN research; provides an overview of clinical features, underlying molecular mechanisms, and therapeutic approaches; and highlights areas for future studies. • BIPN incidence can increase with rise in global tumor incidence and survival time. • BIPN severely affects chemotherapy efficacy and quality of life. • No recommended therapies are available for BIPN according to ASCO guidelines. • Research and development on BIPN mechanisms and drugs are needed.