Neurotoxicity of Cancer Therapies

Jorg Dietrich, MD, PhD, FAAN Neuro-oncology p. 1646-1672 December 2020, Vol.26, No.6 doi: 10.1212/CON.0000000000000943
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PURPOSE OF REVIEW This article reviews neurologic complications associated with chemotherapy, radiation therapy, antiangiogenic therapy, and immunotherapy.

RECENT FINDINGS Cancer therapies can cause a wide range of neurologic adverse effects and may result in significant patient morbidity and mortality. Although some treatment-associated neurologic complications manifest acutely and are often reversible and transient, others occur with delayed onset, can be progressive, and are uniquely challenging to patient management. With an increase in multimodality and combination therapies, including targeted therapies and immunotherapies, and prolonged patient survival, novel and unique patterns of neurologic complications have emerged.

SUMMARY Both conventional and novel cancer therapies can adversely affect the nervous system, thereby producing a wide range of neurologic complications. Increased awareness among neurologists and early recognition of cancer therapy–induced neurotoxic syndromes is critically important to minimize patient morbidity, prevent permanent injury, and improve patient outcomes.

Address correspondence to Dr Jorg Dietrich, Massachusetts General Hospital Cancer Center, 55 Fruit St, Boston, MA 02114, [email protected].

RELATIONSHIP DISCLOSURE: Dr Dietrich has received personal compensation for serving as a consultant for Blue Earth Diagnostics and Unum Therapeutics and publishing royalties from Wolters Kluwer N.V.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Dietrich reports no disclosure.

© 2020 American Academy of Neurology.