Predicting taxane-induced peripheral neuropathy by nailfold capillaroscopy: The CAPNEU pilot study

Area of Science:

• Oncology
• Neurology
• Vascular Biology

Background:

• Taxane-induced peripheral neuropathy (TIPN) is a common, dose-limiting toxicity in breast cancer treatment.
• Predictive biomarkers for TIPN are currently lacking.
• Nailfold capillaroscopy (NFC) assesses microvascular morphology, potentially indicating neuropathy risk.

Purpose of the Study:

• To investigate the association between baseline NFC morphology and taxane-related neuropathy severity and symptom burden.
• To explore Receiver Operating Characteristic (ROC)-derived thresholds of NFC parameters for identifying clinically significant neuropathy.

Main Methods:

• A pilot cohort of 48 breast cancer patients receiving taxane-based regimens underwent baseline NFC.
• NFC parameters (capillary density, width, loop diameter, length) were recorded.
• Neuropathy was assessed using NCI-CTCAE scores and EORTC QLQ-CIPN20, with ROC analyses performed to identify predictive thresholds.

Main Results:

• Regimen-specific associations between NFC parameters and neuropathy were observed.
• Capillary density (CD) correlated with neuropathy in the carboplatin-paclitaxel (CPAC) group.
• Capillary loop diameter (CLD) showed the strongest overall discrimination for predicting neuropathy (NCI ≥ 2).

Conclusions:

• Baseline NFC morphology is associated with taxane-related neuropathy outcomes in a regimen-dependent manner.
• Exploratory ROC thresholds were identified for predicting clinically significant neuropathy.
• CLD emerged as a promising marker, with CD and capillary length (CL) showing potential in specific subgroups, warranting further validation.