Chemotherapy: neurologic complications

Eudocia Quant Lee MD MPH (

Dr. Lee of Harvard Medical School, Dana-Farber Cancer Institute, and Brigham and Women's Hospital received consulting fees from Eli Lilly.

)
Jorg Dietrich MD PhD (

Dr. Dietrich of Harvard Medical School and Massachusetts General Hospital received consulting fees from Unum Therapeutics and Monteris Medical Corporation.

)
Patrick Y Wen MD (

Dr. Wen of Harvard Medical School, Dana-Farber Cancer Institute, and Brigham and Women’s Hospital received research support from Agios, Astra Zeneca, Beigene, Eli Lily, Genentech/Roche, Kazia, Merck, MediciNova, Novartis, Oncoceutics, Sanofi-Aventis, Vascular Biogenics, and VBI Vaccines; is on the advisory board for Abbvie, Agios, Astra Zeneca, Agios, Eli Lilly, Genentech/Roche, Immunomic Therapeutics, Kiyatec, Puma, Taiho, Vascular Biogenics, Deciphera, and VBI Vaccines; has received honorariums for speaking engagements Merck and Prime Oncology.

)
Rimas V Lukas MD, editor. (

Dr. Lukas of Northwestern University Feinberg School of Medicine received honorariums from AbbVie as a guest speaker, from NewLink Genetics and Reneuron for consulting work, and from Monetris as an advisory board member.

)
Originally released December 10, 1996; last updated December 20, 2018; expires December 20, 2021

This article includes discussion of chemotherapy: neurologic complications and neurologic complications of systemic anticancer therapies. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

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, immunotherapy, CAR T cell therapy, and various monoclonal antibodies have 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 both conventional chemotherapy and novel anti-cancer therapies in this article.

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 targeted agents and immunotherapies are also associated with neurologic complications.

 

• Early recognition and prevention may help avoid permanent neurologic damage.

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