Peripheral neurotoxicity of microtubule inhibitor chemotherapeutic agents. Part 1. History of taxanes, mechanism of therapeutic action, clinical symptoms (literature review)

Chemotherapy‑induced peripheral polyneuropathy (CIPN) is one of the most common complications of anticancer therapy. It often leads to early suspension of treatment or dose reduction and represents a serious problem, as there are currently no effective methods for the prevention and treatment of this syndrome.

This review summarizes data on the epidemiology and clinical presentation of the disease and examines the mechanisms of taxanes antitumor action.

Taxanes are anticancer drugs that target microtubules, which are highly dynamic cytoskeletal structures. One of the most frequently used and neurotoxic agents in this group is paclitaxel. By binding to the inner surface of microtubules near the nucleotide‑binding site of β‑tubulin, paclitaxel inhibits tubulin depolymerization. This disrupts the mitotic spindle formation, blocks the cell cycle in tumor cells at the G2/M phase, arrests mitosis, and triggers apoptotic programmed cell death. Mitochondrial-modulated non-apoptotic cell death is considered to be of great importance. The therapeutic activity of paclitaxel also depends on its effects on various cell populations present in the tumor microenvironment.

Clinical presentation of paclitaxel toxicity on the peripheral nervous system is characterized by bilateral, distal, symmetrical axonal neuropathy. Clinical variants of the disease, including persistent neuropathy, are described.

Author’s contribution:
Savateeva-Lyubimova T.N. – selection and analysis of scientific literature, writing text, approval of the final version of the article, responsibility for the integrity of all parts of the article;
Sivak K.V., Stosman K.I. – editing.

Conflict of interest. The authors declare no apparent or potential conflicts of interest related to the publication of this article.

Funding. The study had no financial support.

Received: May 5, 2026 / Revised: June 2, 2026 / Accepted: August 3, 2026 / Published: September 16, 2026

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