The role of growth factors in the prevention and treatment of chemotherapy-induced peripheral neurotoxicity

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a major clinical problem since it is the dose-limiting side effect of a significant number of antineoplastic drugs. The incidence of CIPN varies depending on the conditions, but severe neuropathy can occur in up to 40% of patients undergoing a polichemotherapy regimen. Moreover, even when CIPN is not a dose-limiting side effect, its onset may severely affect the quality of life of cancer patients and cause chronic discomfort. Currently, no treatment is available which can significantly improve the clinical signs and symptoms of CIPN. In recent years, new agents have been proposed as neuroprotectants, and some of them have been more specifically studied for CIPN. So far, the most interesting results for future applications have been obtained in the pre-clinical studies involving cytokines and growth factors. For several of these drugs, in fact, sound hypotheses have been formulated to support the idea of a protective role on selected neuronal targets. However, this theoretical basis has frequently failed to lead to consistent results in pre-clinical and clinical applications. We will review the state-of-the-art of CIPN treatment with growth factors and focus on the future prospects opened up by the most recent pre-clinical and clinical studies.