Which chemotherapy agents are most associated with chemotherapy-induced peripheral neuropathy?

• A. Taxanes
• B. Anthracyclines
• C. Platinum agents and vinca alkaloids
• D. Alkylating agents

Answer: (C)

Chemotherapy-induced peripheral neuropathy results from direct injury to peripheral nerves, and some drugs carry a higher risk. Platinum compounds (like cisplatin, carboplatin, and oxaliplatin) damage sensory neurons in the dorsal root ganglia, leading to dose-dependent sensory numbness and tingling in a stocking-glove distribution, and often persistent neuropathy. Vinca alkaloids (such as vincristine, vinblastine, and vinorelbine) disrupt microtubule function, impairing axonal transport and causing peripheral neuropathy that can affect both sensation and motor function; vincristine is especially notorious for neurotoxicity. While other agents can cause neuropathy, platinum compounds and vinca alkaloids are the ones most classically and reliably linked to this toxicity.