| Severity of symptoms | Dose modification |
| Grade 1 (asymptomatic, loss of deep tendon reflexes or paresthesia without pain or loss of function) | No action needed |
| Grade 2 (interfering with function but not activities of daily living) or Grade 1 with pain | Reduce dose to 1 mg/m2 |
| Grade 3 (interfering with activities of daily living) or Grade 2 with pain | Withhold until toxicity resolved, may reinitiate at 0.7 mg/m2 once weekly |
| Grade 4 (life-threatening, disabling, eg, paralysis) | Discontinue therapy |
