Therapeutics for Chemotherapy-Induced Peripheral Neuropathy: Approaches with Natural Compounds from Traditional Eastern Medicine

Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) often develops in patients with cancer treated with commonly used anti-cancer drugs. The symptoms of CIPN can occur acutely during chemotherapy or emerge after cessation, and often accompany long-lasting intractable pain. This adverse side effect not only affects the quality of life but also limits the use of chemotherapy, leading to a reduction in the survival rate of patients with cancer. Currently, effective treatments for CIPN are limited, and various interventions are being applied by clinicians and patients because of the unmet clinical need. Potential approaches to ameliorate CIPN include traditional Eastern medicine-based methods. Medicinal substances from traditional Eastern medicine have well-established analgesic effects and are generally safe. Furthermore, many substances can also improve other comorbid symptoms in patients. This article aims to provide information regarding traditional Eastern medicine-based plant extracts and natural compounds for CIPN. In this regard, we briefly summarized the development, mechanisms, and changes in the nervous system related to CIPN, and reviewed the substances of traditional Eastern medicine that have been exploited to treat CIPN in preclinical and clinical settings.

Magnolin Inhibits Paclitaxel-Induced Cold Allodynia and ERK1/2 Activation in Mice

“…For example, narcotic analgesics are derived from opium and have been used for thousands of years as a potent pain treatment. The strategy of isolating analgesic candidates from plants with known empirical efficacy can help in the development of successful analgesics for CIPN [ 22 ]. However, a single medicinal substance typically contains numerous active ingredients, and which of these are selected and tested as candidates is the key to successful candidate identification.…”

Peripheral neuropathy associated with monomethyl auristatin E-based antibody-drug conjugates

“…Docetaxel was shown to induce mechanical and thermal dyspepsia, as well as abnormal cold dyspepsia, but continuous oral administration of duloxetine was effective in reducing the resulting neuropathic pain symptoms. 109 The American Society of Clinical Oncology (ASCO) guidelines suggest that duloxetine has the strongest data support for the treatment of neuropathic pain related to peripheral neuropathy. 110 In a multicenter, randomized, double-blind, and crossover trial, patients receiving duloxetine initially had significantly lower pain scores than those receiving a placebo.…”

5,7-Dimethoxycoumarin ameliorates vincristine induced neuropathic pain: potential role of 5HT3 receptors and monoamines

“…Such therapies modify serotonergic, adrenergic, excitatory amino acid or opioidergic pathways to produce anti-allodynic effects with unsatisfactory clinical outcomes associated with serious adverse effects, including dependence ( Wiffen et al, 2017 ; Cho et al, 2021 ). Considering the complex nature of neuropathic pain, and the serious efficacy and tolerability issues of currently available therapies, there is an ongoing search for potential molecules, both natural and synthetic ( Chung and Kim, 2022 ), for the treatment of VINP.…”

“…Considering the complex nature of neuropathic pain, and the serious efficacy and tolerability issues of currently available therapies, there is an ongoing search for potential molecules, both natural and synthetic (Chung and Kim, 2022), for the treatment of VINP.…”