Which chemotherapeutic agent is associated with severe peripheral neuropathy?

Cisplatin is the chemotherapeutic agent most commonly associated with severe peripheral neuropathy. This condition arises due to cisplatin's mechanism of action, which involves forming DNA cross-links, leading to cellular damage. The neurotoxicity can manifest not only as peripheral neuropathy but also as other neurotoxic effects such as ototoxicity.

Peripheral neuropathy from cisplatin can present with symptoms such as tingling, numbness, and pain, often affecting the distal extremities. This side effect is attributed to cisplatin's potential to damage peripheral nerves, particularly the axons and neuronal cells, due in part to the accumulation of the drug in the nervous tissue.

While other agents listed can also have neuropathic effects, they are less pronounced than those seen with cisplatin. For example, cyclophosphamide is primarily known for its effects on the hematological system and has a different side effect profile. Vinblastine can cause neuropathy primarily at higher doses but typically results in less severe symptoms compared to cisplatin. Doxorubicin can lead to several side effects, including cardiotoxicity, but peripheral neuropathy is not its hallmark adverse effect. This distinction makes cisplatin the most significant drug associated