Neurofilaments as Prognostic Biomarkers in the Assessment of the Risk of Advanced Taxane-Induced Neuropathy in Breast...

Area of Science:

• Oncology
• Neurology
• Biochemistry

Background:

• Chemotherapy-induced peripheral neuropathy (CIPN) is a common dose-limiting toxicity in breast cancer patients receiving taxane-based neoadjuvant chemotherapy (NAC).
• Current methods for assessing CIPN rely on subjective patient-reported symptoms, potentially delaying diagnosis and intervention.

Purpose of the Study:

• To evaluate the clinical utility of serum neurofilament light chain (NF-L) concentrations for diagnosing and assessing the severity of CIPN during NAC in breast cancer patients.
• To establish NF-L as an objective biomarker for early detection of neuropathy.

Main Methods:

• A cohort of 94 breast cancer patients undergoing NAC with taxanes was studied.
• Serum NF-L levels were measured using Ella technology at multiple time points: before NAC, after three and six cycles, and 3-6 months post-NAC.
• CIPN was assessed using the EORTC QLQ-CIPN20 questionnaire.

Main Results:

• Serum NF-L concentrations increased during NAC and significantly decreased post-therapy (p = 0.001).
• A cut-off NF-L level of 29.5 pg/mL distinguished controls from patients with early neuropathy (CIPN G1) (AUC = 0.982).
• Higher NF-L levels correlated with increased neuropathy severity (p = 0.0189) and specific cut-offs identified low-grade (≥196 pg/mL) and advanced (≥218 pg/mL) CIPN.

Conclusions:

• Serum NF-L levels provide an objective and early method for confirming neuropathy in breast cancer patients during NAC.
• NF-L measurement is valuable for assessing the severity of taxane-induced neuropathy, complementing subjective assessments.
• This biomarker can aid in timely clinical decisions regarding chemotherapy management.