Management of neurotoxic reactions induced by antibody-drug conjugates

In recent years, many new antitumor drugs have been approved for clinical use. Among them, antibody-drug conjugates (ADCs) are an innovative drug group that combines the advantages of chemotherapy with a cytotoxic drug and targeted therapy with monoclonal antibodies. However, although ADCs provide survival benefits to patients, their special composition and mode of action also lead to specific adverse effects. Among the common adverse effects caused by ADCs, peripheral neuropathy (PN) affects patients’ quality of life and also present significant challenges to clinical nursing. There are several guidelines and consensus for treating chemotherapy-induced peripheral neuropathy. However, there are no specific guidelines for managing PN caused by ADCs. Nurses play an important role in the prevention and management of PN, and their relevant knowledge and skills for symptom assessment, functional deficit screening, patient referral and advocacy, and patient education are indispensable. By combining Chinese and international guidelines, consensus, and related studies, this paper reviewed the occurrence and characteristics of ADC-induced PN and highlighted the principles of prevention, treatment, and nursing care to provide a reference for clinical nursing practice and improve the safety of ADCs for patients.