Thalidomide neurotoxicity

Briani, Chiara; Zara, Gabriella; Rondinone, R; Libera, S Della; Ermani, Mario; Ruggero, Susanna; Ghirardello, Anna; Zampieri, Sandra; Doria, Andrea

doi:10.1212/01.wnl.0000130499.91775.2c

Cited by 72 publications

(42 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is estimated that thalidomide‐induced polyneuropathy affects from 20% to 60% of all thalidomide‐treated cancer patients (Cavaletti et al., 2004; Clemmensen, Olsen, & Andersen, 1984; Plasmati et al., 2007). The mechanism of thalidomide‐induced neurotoxicity is not completely clear; however, studies suggest that it might be prompted by nuclear factor‐kappaB‐related dysregulation of neurotrophins that are critical for sensory neuron survival (Briani et al., 2004). Furthermore, growing evidence indicates that old age and pre‐existing predisposition to nerve diseases resulting from a polymorphism of genes involved in nerve repair might play a crucial role in developing a thalidomide‐induced polyneuropathy (Johnson et al., 2011).…”

Section: Thalidomide and Its Analogsmentioning

confidence: 99%

Chemotherapy‐induced neuropathies—a growing problem for patients and health care providers

2016

View full text Add to dashboard Cite

IntroductionChemotherapy‐induced neuropathies are one of the most common side effects of cancer treatment, surpassing bone marrow suppression and kidney dysfunction. Chemotherapy effects on the nervous system vary between different classes of drugs and depend on specific chemical and physical properties of the drug used. The three most neurotoxic classes of anti‐cancer drugs are: platinum‐based drugs, taxanes, and thalidomide and its analogs; other, less neurotoxic but also commonly used drugs are: bortezomib, ixabepilone, and vinca alkaloids.MethodsHere, in this paper, based on our experience and current knowledge, we provide a short review of the most common, neuropathy‐inducing anti‐cancer drugs, describe the most prevalent neuropathy symptoms produced by each of them, and outline preventive measures and treatment guidelines for cancer patients suffering from neuropathy and for their health care providers.ResultsPatients should be encouraged to report any signs of neuropathic pain, alteration in sensory perception, tingling, numbness, burning, increased hot/cold sensitivity and motor dysfunctions as early as possible. If known neurotoxic chemotherapeutics are used, a neurological examination with electrophysiological evaluation should be implemented early in the course of treatment so, both patients and physicians would be better prepared to cope with possible neurotoxic effects.ConclusionsThe use of neurotoxic chemotherapeutics should be closely monitored and if clinically permitted, that is, if a patient shows signs of cancer regression, drug doses should be reduced or combined with other less neurotoxic anti‐cancer medication. If not counteractive, the use of over the counter antineuropathic supplements such as calcium or magnesium might be encouraged. If physically possible, patients should also be encouraged to exercise regularly and avoid factors that might increase nerve damage such as excessive drinking, smoking, or sitting in a cramped position.

show abstract

Section: Thalidomide and Its Analogsmentioning

confidence: 99%

Chemotherapy‐induced neuropathies—a growing problem for patients and health care providers

2016

View full text Add to dashboard Cite

show abstract

“…The neuropathy partially remitted at the electromyographic follow-up 12 months after suspension. Peripheral neuropathy is a known complication of thalidomide treatment [22]. Accurate neurological examination and measurement of sensory nerve action potential amplitudes of the sural, median and radial nerves is therefore useful before treatment and at a follow-up every 6 months [22].…”

Section: Discussionmentioning

confidence: 99%

Thalidomide in the Treatment of Kaposi’s Sarcoma

Rubegni¹,

Sbano²,

Aloe³

et al. 2007

Dermatology

View full text Add to dashboard Cite

Background: Kaposi’s sarcoma (KS) is a lymphangioproliferative tumour. Therapy of KS depends on the characteristics of the disease, especially area and growth rate of lesions, and patient condition. Currently symptomatic resectable lesions are excised, whereas more advanced disease and unresectable lesions are treated with radiotherapy. If a large area or internal organs are affected or other treatments fail, chemotherapy is used. Recently some authors have reported their encouraging experience in the use of thalidomide in patients with AIDS-related KS. Objective: To evaluate the efficacy of thalidomide in 3 patients with non-AIDS-related KS. Methods: Two patients with classic widespread cutaneous and 1 with iatrogenic cutaneous and visceral KS were treated with thalidomide (100 mg/day) for 12 months. Results: In all 3 patients partial remission was evident after 4 months of thalidomide therapy; in 2 out of 3 complete remission was achieved after 12 months of treatment. Conclusions: Our results seem to confirm the utility of thalidomide in the treatment of non-AIDS-related KS.

show abstract

“…Electrophysiologic alterations may persist and even worsen after thalidomide discontinuation, suggesting a prolonged neurotoxic effect. 59 Aside from strict precautions for the use of this drug in women of childbearing potential (appropriate contraception), polyneuropathy is the major limiting toxicity of thalidomide. The manufacturer has developed a comprehensive program to control prescribing, dispensing, and use of this drug, known as the System for Thalidomide Education and Prescribing Safety (S.T.E.P.S.).…”

Section: Systemic Treatment Options For Patients With Refractory Disementioning

confidence: 99%