Neurofilament Light Chain: A Potential Biomarker for Chemotherapy-Induced Peripheral Neuropathy in Adolescent Young...

Background: Neurofilament light chain (NfL)is a promising biomarker of axonal injury and may facilitate earlier detection of chemotherapy-induced peripheral neuropathy (CIPN). This study evaluated longitudinal changes in NfL and its association with patient-reported CIPN symptoms in adolescents and young adults receiving neurotoxic chemotherapy. Methods: In this prospective, single-center study, patients >10 years of age with cancer receiving atubulin toxin were enrolled. Serum NfL and the Functional Assessment of Cancer Therapy-Gynecologic Oncology Group-Neurotoxicity (FACT-GOG-NTx) questionnaire were collected at baseline, midchemotherapy, and at the follow-up visit closest to 90 days after therapy initiation.Results: Eleven participants (median age 17 years [range, 12-24]; 63.6% male) were included. NfL levels increased longitudinally in all participants, with a median maximum increase from baseline of 112.5% (range, -32.0% to 4896.2%). Mean NfL levels increased from 2.32 at baseline (median 2.16) to 3.28 at mid-chemotherapy (median 3.47) and remained elevated at the follow-up visit (mean 3.85; median 4.38). Higher NfL levels were associated with worse FACT-GOG-NTx scores during chemotherapy (r = -0.32, p ≤ 0.01) and after chemotherapy (r = -0.31, p < 0.01).Conclusions: NfL increased throughout treatment and was associated with patient reported CIPN symptoms, supporting its potential as an objective biomarker for early detection and monitoring of chemotherapy-induced peripheral neuropathy in adolescents and young adults receiving neurotoxic chemotherapy.