Neurotoxicity of chemotherapy and brain-radiotherapy in cancer: overlapping mechanisms underlying cognitive impairment

Cancer and its treatments often result in cognitive impairment (CRCI), impacting the well-being of survivors. Chemotherapy and brain-targeted radiation therapy contribute significantly to central nervous system toxicity, which underlies these cognitive issues. Preclinical animal studies serve as pivotal tools in elucidating the cellular and molecular changes triggered by cancer therapies. This review assesses both clinical and preclinical evidence, offering insights into optimal preclinical study designs to deepen our understanding of the underlying injury mechanisms. Such understanding is crucial and adapted to precision medicine for advancing preventive and restorative interventions. Early interventions show promising outcomes, underscoring the importance of identifying predictive biomarkers for patient stratification.