Chemobrain: A review on mechanistic insight, targets and treatments

Vanishree Rao, Rashmi Bhushan, Priyanka Kumari, Sri Pragnya Cheruku, V. Ravichandiran, Nitesh Kumar

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Citations (Scopus)


Chemo-brain refers to the thinking and memory problems that occur in cancer patients during and after chemotherapy. It is also known as cognitive dysfunction or chemo-fog. Risk factors include brain malignancies, either primary or metastatic, radiotherapy and chemotherapy, either systemic or brain targeted. There are various mechanisms by which chemo-brain occurs in patients post-chemotherapy, including inflammation of neurons, stress due to free radical generation, and alterations in normal neuronal cell process due to biochemical changes. While chemotherapy drugs that are non-brain targeted, usually fail to cross the blood-brain barrier (BBB), this is not the case for inflammatory cytokines that are released, which easily cross the BBB. These inflammatory neurotoxic agents may represent the primary mediators of chemobrain and include the pro-inflammatory cytokines such as interleukins 1 and 6 and tumor necrosis factor. The pronounced rise in oxidative stress due to continuous chemotherapy also leads to a reduction in neurogenesis and gliogenesis, loss of spine and dendritic cells, and a reduction in neurotransmitter release. Based on recent research, potential agents to prevent and treat chemo brain have been identified, which include Lithium, Fluoxetine, Metformin, Rolipram, Astaxanthin, and microglial inhibitors. However, more defined animal models for cognitive dysfunction are required to study in detail the mechanisms involved in chemo-brain; furthermore, well-defined clinical trials are required to identify drug targets and their therapeutic significance. With these focused approaches, the future for improved therapies is promising.

Original languageEnglish
Title of host publicationStrategies to Mitigate the Toxicity of Cancer Therapeutics
EditorsDavid A. Gewirtz, Paul B. Fisher
PublisherAcademic Press Inc.
Number of pages48
ISBN (Print)9780323900874
Publication statusPublished - 01-2022

Publication series

NameAdvances in Cancer Research
ISSN (Print)0065-230X
ISSN (Electronic)2162-5557

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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