Collateral Damage in Cancer Chemotherapy: Oxidative Stress in Nontargeted Tissues

Proposed mechanism of DOX-induced oxidative stress in brain. DOX leads to increased levels of circulating TNF-α, which can pass the blood-brain barrier and trigger local production of TNF-α in the brain. Increased levels of TNF-α may in turn induce the expression of nitric oxide synthases, leading to oxidative stress.