Which chemotherapy agent can lead to peripheral neuropathy symptoms like foot drop and numbness?

Vincristine is a chemotherapy agent that is particularly known for causing peripheral neuropathy. This side effect arises due to vincristine's mechanism of action, which involves disrupting microtubule formation during cell division. However, this disruption also affects nerve cells, leading to symptoms such as foot drop, numbness, and tingling sensations.

Peripheral neuropathy with vincristine often results from its binding to the tubulin in neurons, which can lead to axonal damage. This condition may present as motor and sensory deficits, often in a glove and stocking distribution since the longest nerves (in the limbs) are typically affected first. Symptoms may vary in severity, with some patients experiencing significant discomfort and the potential for functional impairment.

In contrast, the other agents listed—Cisplatin, Bleomycin, and Methotrexate—do not typically cause peripheral neuropathy to the same extent. For example, Cisplatin can cause ototoxicity and renal toxicity, while Bleomycin is more associated with pulmonary toxicity. Methotrexate primarily targets rapidly dividing cells but does not have the same neurotoxic effect as vincristine. Therefore, vincristine's specific profile directly links it to the development of peripheral neuropathy,