| Body System | Comments | Mechanisms |
| Neurologic [10] [11] | Cognitive impairment Peripheral neuropathy Loss of proprioception | Cytokine dysregulation Damage to neuronal cell bodies in dorsal root ganglion Axonal membrane ion channel dysfunction |
| Psychiatric [12] | Depression Anxiety Negative body image | Inflammation Hyperactive hypothalamic-pituitary-adrenal axis Glutamate excitotoxicity |
| Dermatologic [13] | Alopecia Rash Plantar-palmar erythrodysesthesia Allergy Mouth sores Discolored nails | EGFR inhibition Allergic IgE mediated reactions Drug extravasation; direct damage Increased expression of enzymes necessary for capecitabine activation |
| Pulmonary [14] | Pneumonitis Pulmonary fibrosis | Proinflammatory cytokines: IL-6; IL-8; TMF T-cell proliferation Acute phase protein production Infectious etiology: viral, bacterial, fungal |
| Cardiac [15] | Cardiomyopathy | Rapid apoptosis or necrosis of myocytes Mitochondrial damage, changes in ATP production |
| Gastrointestinal [16] | Nausea and vomiting Diarrhea Constipation Bowel fistulization/perforation | Alterations in microbiome Increases intestine wall permeability Inflammatory responses |
| Genito-urinary [17] | Hemorrhagic cystitis Sexual dysfunction Renal failure | Estrogen deficiency Nephrotoxicity Inflammatory response, reactive oxygen species, nitric oxide production |
| Hematologic [18] | Bone marrow suppression Myelodysplastic syndrome/secondary leukemias | Direct destruction of bone marrow populations Quantitative reduction in hematopoietic stem cell (HSC) due to apoptosis Qualitative changes in HSC replicative function Damage to bone marrow stromal cells |
| Immunologic [19] | Auto-immune syndromes from immunotherapy | Enhanced activation of T-cells |