Which type of chemotherapy is associated with causing painful nerve damage?

Microtubule inhibitors are known to cause peripheral neuropathy, which is a painful nerve damage. These drugs, which include taxanes and vinca alkaloids, work by disrupting microtubule function, which is essential for cell division. When microtubule assembly and disassembly are interfered with, it leads not only to the desired anti-tumor effects but also results in neurotoxic side effects. The mechanism by which these agents cause nerve damage is not entirely understood, but it is thought that their action on neuronal microtubules leads to changes in the structure and function of nerve cells.

In contrast, alkylating agents, antimetabolites, and topoisomerase inhibitors have their own specific side effects, but they are not primarily associated with causing painful nerve damage like microtubule inhibitors. Alkylating agents typically affect the DNA and may cause issues like bone marrow suppression or secondary cancers, antimetabolites can interfere with DNA synthesis, leading to nausea or diarrhea, and topoisomerase inhibitors also focus on nuclear DNA processes without the same kind of peripheral nerve toxicity.