Prospective assessment of serum neurofilament light chain in platinum-induced and taxane-induced peripheral neuropathy

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a potentially disabling complication of the neurotoxic chemotherapies; however, its occurrence is often unpredictable. We aimed to determine whether serum levels of neurofilament light chain (sNfL) could predict the onset and severity of CIPN, and whether sNfL levels were associated with other clinical factors in people with cancer. Methods: Adult patients (>18 years) prescribed at least four cycles of oxaliplatin, cisplatin, docetaxel or paclitaxel were clinically assessed and had blood taken for sNfL analysis at baseline and prior to each cycle. Peak sNfL was compared with clinical characteristics and Total Neuropathy Score-Clinical version (TNSc), National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE, V.4.03) and CIPN-Rasch-built Overall Disability Scale (CIPN-RODS). Individual patient trends in sNfL and TNSc were examined. Results: 42 patients completed the study, with 36 receiving platinum agents and 6 receiving taxanes. Peak sNfL was higher with taxanes than with platinum agents (129.9 vs 31.0 pg/mL; p