Paola Alberti

Università degli Studi di Milano-Bicocca | UNIMIB · School of Medicine and Surgery

Background and Aims Chemotherapy‐induced peripheral neurotoxicity (CIPN), with paraesthesia, numbness, dysesthesia and neuropathic pain ranks among the most common dose‐limiting toxicity of several widely used anticancer drugs. Recent studies revealed the microvascular angiogenesis as a new important actor, beside peripheral neurons, in the neuroto...

Background and Purpose Chemotherapy‐induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient‐reported outcomes measures, but this approach can be challenging in patient care. This multicenter European study aims to bridge th...

Background Supportive care to ensure optimal quality of life is an essential component of cancer care and symptom control across the lifespan. Ongoing advances in cancer treatment, increasing toxicity from many novel treatment regimes, and variations in access to care and cancer outcomes across the globe and resource settings present significant ch...

Introduction: Chemotherapy induced peripheral neurotoxicity (CIPN) is a long-lasting, or even permanent, late toxicity caused by largely used anticancer drugs. CIPN affects a growing population of cancer survivors and diminishes their quality of life since there is no curative/preventive treatment. Among several reasons for this unmet clinical nee...

Peripheral neurotoxicity is a dose-limiting adverse reaction of primary frontline chemotherapeutic agents, including vincristine. Neuropathy can be so disabling that patients drop out of potentially curative therapy, negatively impacting cancer prognosis. The hallmark of vincristine neurotoxicity is axonopathy, yet its underpinning mechanisms remai...

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating toxicity of many drugs used in cancer treatment. There are numerous available strategies for preventing or treating CIPN, but few are guideline-recommended, due to limited evidence of their effectiveness. The primary objective of this survey was to understand what strategi...

The peripheral nervous system can encounter alterations due to exposure to some of the most commonly used anticancer drugs (platinum drugs, taxanes, vinca alkaloids, proteasome inhibitors, thalidomide), the so-called chemotherapy-induced peripheral neurotoxicity (CIPN). CIPN can be long-lasting or even permanent, and it is detrimental for the quali...

Paclitaxel-induced peripheral neurotoxicity (PIPN) is a potentially dose-limiting side effect in anticancer chemotherapy. Several animal models of PIPN exist, but their results are sometimes difficult to be translated into the clinical setting. We compared 2 widely used PIPN models characterized by marked differences in their methodologies. Female...

Since Academic Year 2023/2024 first year medicine students were provided with the opportunity to exploit interactive tools for macroscopic anatomy teaching activities via peer-to-peer tutoring: fourth- and fifth-year students in Medicine and Surgery were trained to take care of this. First year medical students (from the Italian [n=160] and Interna...

Purpose This white paper provides guidance regarding the process for establishing and maintaining international collaborations to conduct oncology/neurology-focused chemotherapy-induced peripheral neurotoxicity (CIPN) research. Methods An international multidisciplinary group of CIPN scientists, clinicians, research administrators, and legal exper...

Peripheral neurotoxicity is a dose-limiting adverse reaction of primary frontline chemotherapeutic agents, including vincristine. Neuropathy can be so disabling that patients drop out of potentially curative therapy, negatively impacting cancer prognosis. The hallmark of vincristine neurotoxicity is axonopathy, yet its underpinning mechanisms remai...

Purpose Clinical practice guidelines recommend altering neurotoxic chemotherapy treatment in patients experiencing intolerable chemotherapy-induced peripheral neuropathy (CIPN). The primary objective of this survey was to understand patient’s perspectives on altering neurotoxic chemotherapy treatment, including their perceptions of the benefits of...

Background and Aims Chemotherapy‐induced peripheral neurotoxicity (CIPN) is one of the most common dose‐limiting side‐effects of paclitaxel (PTX) treatment. Many age‐related changes have been hypothesized to underlie susceptibility to damage or impaired regeneration/repair after nerve injury. The results of these studies, however, are inconclusive...

Background and Aims Chemotherapy‐induced peripheral neurotoxicity (CIPN) is a common and long‐lasting adverse event of several anticancer compounds, whose treatment is still lacking. To fill this gap, preclinical studies are warranted, exploiting highly translational outcome measure(s) to transfer data from bench to bed side. Nerve excitability tes...

Purpose Clinical practice guidelines recommend altering neurotoxic chemotherapy treatment in patients experiencing intolerable chemotherapy-induced peripheral neuropathy (CIPN). The primary objective of this survey was to understand patient’s perspectives on altering neurotoxic chemotherapy treatment, including their perceptions of the benefits of...

Gait analysis could be used in animal models as an indicator of sensory ataxia due to chemotherapy-induced peripheral neurotoxicity (CIPN). Over the years, gait analysis in in vivo studies has evolved from simple observations carried out by a trained operator to computerised systems with machine learning that allow the quantification of any variabl...

Among the possible models of chemotherapy-induced peripheral neurotoxicity (CIPN), there is a quite peculiar one induced by Oxaliplatin (OIPN). OIPN is a frequent side effect of chemotherapy regimens and has a relevant medical and socio-economic impact. OIPN has no cure since underlying mechanisms are still not fully understood. OIPN consists of an...

Background and aims: Several widely used medications, with a relevant efficacy profile, are toxic to the peripheral nervous system and an even larger number of agents are suspected to be neurotoxic. There are concerns about the use of these drugs in patients with Charcot-Marie-Tooth disease (CMT), a hereditary motor and sensory neuropathy. This re...

Peripheral neuropathies are common conditions whose treatment, in most cases, is still lacking. Preclinical animal models are crucial to solve this unmet need, but highly translational outcome measures are needed to promptly translate data from bench to bedside. High resolution diffusion MRI could be a surrogate, translational, biomarker to charact...

Chemotherapy Induced Peripheral Neurotoxicity (CIPN) is a longlasting adverse event of most commonly used anticancer drugs, potentially causing sensory loss and neuropathic pain at limb extremities. Cancer survivors affected by CIPN can experience diminished working abilities, in particular due to sensory ataxia. In some cases, they may no longer b...

Purpose Chemotherapy-induced peripheral neurotoxicity (CIPN) is a highly prevalent, dose-limiting, costly, and tough-to-treat adverse effect of several chemotherapy agents, presenting as sensory and motor dysfunction in the distal extremities. Due to limited effective treatments, CIPN can permanently reduce patient function, independence, and quali...

Multiple pathological mechanisms are involved in the development of chemotherapy-induced peripheral neurotoxicity (CIPN). Recent work has provided insights into the molecular mechanisms underlying chemotherapy-induced axonal degeneration. This review integrates evidence from preclinical and clinical work on the onset, progression and outcome of axo...

Oxaliplatin (OHP)-induced peripheral neurotoxicity (OIPN), one of the major dose-limiting side effects of colorectal cancer treatment, is characterized by both acute and chronic syndromes. Acute exposure to low dose OHP on dorsal root ganglion (DRG) neurons is able to induce an increase in intracellular calcium and proton concentration, thus influe...

Chemotherapy-induced peripheral neurotoxicity is one of the most common dose-limiting toxicities of several widely used anticancer drugs such as platinum derivatives (cisplatin) and taxanes (paclitaxel). Several molecular mechanisms related to the onset of neurotoxicity have already been proposed, most of them having the sensory neurons of the dors...

Peripheral Neuropathies (PN) are common conditions whose treatment is still lacking in most cases. Animal models are crucial, but experimental procedures should be refined in some cases. We performed a detailed characterization of the ventral caudal nerve to contribute to a more effective assessment of axonal damage in future PN studies. PN was ind...

Simple Summary: Cancer survivors can experience neurological complications after exposure to anticancer therapy. Chemotherapy-induced peripheral neurotoxicity (CIPN), mainly consisting of sensory loss and neuropathic pain in hands and feet, is most commonly encountered. Cognitive impairment, although less frequent, is also a severe adverse event, s...

Pharmacogenomics is a powerful tool to predict individual response to treatment, in order to personalize therapy, and it has been explored extensively in oncology practice. Not only efficacy on the malignant disease has been investigated but also the possibility to predict adverse effects due to drug administration. Chemotherapy-induced peripheral...

Oxaliplatin (OHP)-induced peripheral neurotoxicity (OIPN) is a frequent adverse event of colorectal cancer treatment. OIPN encompasses a chronic and an acute syndrome. The latter consists of transient axonal hyperexcitability, due to unbalance in Na+ voltage-operated channels (Na+VOC). This leads to sustained depolarisation which can activate the r...

Neurons are permanent cells whose key feature is information transmission via chemical and electrical signals. Therefore, a finely tuned homeostasis is necessary to maintain function and preserve neuronal lifelong survival. The cytoskeleton, and in particular microtubules, are far from being inert actors in the maintenance of this complex cellular...

Our aim was to assess the significance of measuring serum neurofilament light chain (sNfL) levels as biomarker of paclitaxel‐induced peripheral neurotoxicity (PIPN). We longitudinally measured sNfL in breast cancer patients, scheduled to receive the 12‐weekly paclitaxel‐based regimen. Patients were clinically examined by means of the Total Neuropat...

Chemotherapy-induced peripheral neurotoxicity is a common dose-limiting side effect of several cancer chemotherapeutic agents, and no effective therapies exist. Here we constructed a systems pharmacology model of intracellular signaling in peripheral neurons to identify novel drug targets for preventing peripheral neuropathy associated with proteas...

Pharmacological strategies for chemotherapy-induced peripheral neurotoxicity (CIPN) are very limited. We systematically reviewed data on rehabilitation, exercise, physical therapy, and other physical non-pharmacological interventions and offered evidence-based recommendations for the prevention and treatment of CIPN. A literature search using PubMe...

Introduction Chemotherapy-induced peripheral neurotoxicity (CIPN) remains a significant toxicity in cancer survivors without preventative strategies or rehabilitation. Exercise and physical activity-based interventions have demonstrated promise in reducing existing CIPN symptoms and potentially preventing toxicity, however there is a significant ga...

Proceedings of the 31st National Conference of the Italian Group for the Study of Neuromorphology “Gruppo Italiano per lo Studio della Neuromorfologia” G.I.S.N., Milan, November 26-27, 2021

Internationally known CIPN scientists and clinicians will provide practical tips and clinical demonstrations to guide busy oncology clinicians to incorporate CIPN assessment into daily practice. Presentations: • Mechanisms of Chemotherapy-Induced Peripheral Neuropathy (CIPN) with Dr M Imad Damaj; • Challenges in Accurately Grading CIPN with Availa...

The authors will present a comprehensive account of the neurological aspects of SARS-CoV-2 infection. The aim is to provide a practical clinical book which will serve as a guide for clinicians from all specialties involved in the management of COVID-19 patients. The authors share the extensive clinical experience gained in major hospitals in Lombar...

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a treatment related toxicity that burdens the quality of life of cancer survivors. Unfortunately, no efficacious treatment (symptomatic or preventive) is available for this condition for many reasons. First, a still incomplete pathogenetic knowledge hampers the recognition of a strong biologic...

Background peripheral neuropathy treatment is not always satisfactory. To fill this gap, inferences from bench side are warranted, where morphological and pathogenetic determinations can be performed. Nerve conduction studies (NCS) are ideal to translate results from preclinical to clinical setting. New Methods we propose a comprehensive 8-minute...

OBJECTIVE There is not agreement on the “gold standard” for detection and grading of Chemotherapy Induced Peripheral Neurotoxicity (CIPN) in clinical trials. We performed an observational prospective study to assess and compare both patient-based and physician-based methods. METHODS Consecutive patients, aged 18 years or older, candidates for ne...

This systematic review provides a high-quality synthesis of the empirical evidence regarding chemotherapy-induced peripheral neuropathy (CIPN) characteristics and patterns described in studies of children who received neurotoxic chemotherapy to treat cancer. PubMed, CINAHL, PsycINFO, and Embase were searched for articles published 2009 - 2019, yiel...

Peripheral neuropathies (PNs) are a type of common disease that hampers the quality of life of affected people. Treatment, in most cases, is just symptomatic and often ineffective. To improve drug discovery in this field, preclinical evidence is warranted. In vivo rodent models allow a multiparametric approach to test new therapeutic strategies, si...

The onset of chemotherapy-induced peripheral neurotoxicity (CIPN) is a leading cause of the dose reduction or discontinuation of cancer treatment due to sensory symptoms. Paclitaxel (PTX) can cause painful peripheral neuropathy, with a negative impact on cancer survivors' quality of life. While recent studies have shown that neuroinflammation is in...

Significance Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating “dying back” neuropathy featuring a distal-to-proximal peripheral nerve degeneration seen in cancer patients undergoing chemotherapy. The pathogenenic mechanisms of CIPN are largely unknown. We report that in sensory neurons, the CIPN-inducing drug bortezomib caused ax...

OBJECTIVES: Oxaliplatin (OHP) induced peripheral neurotoxicity (OIPN), a persistent adverse event of chemotherapy, is characterized by a sensory, length-dependent, chronic polyneuropathy that affects cancer survivors; moreover, OIPN is characterized also by an acute neurotoxicity syndrome. Acute OIPN shows hallmark of axonal hyperexcitability. This...

INTRODUCTION. We demonstrated Topiramate (TPM) prevents Oxaliplatin (OHP) Induced Peripheral Neurotoxicity (OIPN; Alberti et al. 2020) in rats. Moreover, being a carbon anhydrase inhibitor, it can reduce neoangiogenesis and prevent chemoresistance. To verify this, we are searching promising findings in vivo and in vitro. METHODS. In vivo we defined...

INTRODUCTION. Taxane-induced Peripheral Neurotoxicity (TIPN) is a relevant late toxicity that, so far, lacks an efficacious treatment. Neurofilament light chain (NfL) serum levels have emerged as a potential biomarker in neurological diseases and have shown promising usefulness in detecting chemotherapy induced peripheral neurotoxicity in animal mo...

Dear Colleagues, Sodium voltage-operated ion channels (NaV) are widely represented in the peripheral nervous system (PNS), being crucial for action potential generation. Modulators of NaV are attracting interest as potential therapeutic strategies for PNS disorders. They represent a valuable strategy for neuropathic pain management, gaining attent...

Introduction Chemotherapy-induced peripheral neuropathy (CIPN) is a potentially persistent late toxicity of most common anticancer regimens. There is still a huge lack in CIPN assessment in clinical trials; therefore, biomarkers, both neuroimagery and molecular, could fill this gap. Areas covered In this review the first applications of high-resol...

BACKGROUND: Oxaliplatin (OHP) induced peripheral neurotoxicity (OIPN) is a potentially persistent side effect of cancer treatment that hampers colorectal cancer survivors' quality of life; notably, there is no efficacious treatment for OIPN. OIPN consists of two different conditions: an acute and chronic syndrome. Chronic OIPN is characterized by a...

Chemotherapy-Induced Peripheral Neurotoxicity (CIPN) is a severe and long-lasting side effect of anticancer therapy, which can severely impair patients’ quality of life. It is a sensory and length-dependent neuropathy, which predominantly affects large myelinated fibers. Easy and reliable monitoring of CIPN in patients is still an unmet clinical ne...

Peripheral neurotoxicity is a debilitating toxicity that afflicts up to 90% of patients with colorectal cancer receiving oxaliplatin-containing therapy. Although emerging evidence has highlighted the importance of various solute carriers to the toxicity of anticancer drugs, the contribution of these proteins to oxaliplatin-induced peripheral neurot...

In children who receive neurotoxic chemotherapy, peripheral neurotoxicity occurs frequently, necessitates dose reduction or treatment cessation, and affects function and long-term quality of life. No treatments exist for peripheral neurotoxicity and few assessment measures are specific to children. We did a systematic review to analyse the publishe...

At the time of this writing, healthcare systems are facing worldwide the pandemic of the coro-navirus severe acute respiratory coronavirus 2 (SARS-COV-2) and its associated disease, named cronavirus disease 19 (COVID-19). This virus is a new human pathogen, and currently, there are no specific treatment options. 1 COVID-19 mostly affects the respir...

BACKGROUND Peripheral neurotoxicity afflicts up to 90% of patients with colorectal cancer receiving oxaliplatin therapy. Oxaliplatin preferentially accumulates in and causes toxicity to peripheral sensory neurons present in the dorsal root ganglia (DRG), but mechanistic details of the transporters involved in this process remain uncertain. In the p...

Annual meeting organized by SigN (Young Neurologists' section of the Italian Society of Neurology)

Peripheral neuropathy is one of the most common, dose limiting, and long-lasting disabling adverse events of chemotherapy treatment. Unfortunately, no treatment has proven efficacy to prevent this adverse effect in patients or improve the nerve regeneration, once it is established. Experimental models, particularly using rats and mice, are useful t...

Oxaliplatin (OHP) Induced Peripheral Neurotoxicity (OIPN) is one of the dose-limiting toxicities of the drug and these adverse effects limit cancer therapy with L-OHP, used for colorectal cancer treatment. Acute neurotoxicity consists of symptoms that are the hallmarks of a transient axonal hyperexcitability; chronic neurotoxicity has a clinical pi...

Proteasome inhibitors (PIs), especially bortezomib (BTZ), have come to the forefront over the last years because of their unprecedented efficacy mainly against multiple myeloma (MM). Unfortunately, peripheral neuropathy (PN) secondary to treatment of MM with PIs has emerged as a clinically relevant complication, which negatively impacts the quality...