Neurofilament Light Chain: A Potential Biomarker for Chemotherapy-Induced Peripheral Neuropathy in Adolescent Young Adults
Jennifer A. Belsky, Allie Carter, Michael E. Roth, Audrey Leisinger, Jeffery Dage, Etan Orgel, AnnaLynn M. Williams, Bryan P. Schneider, Ellen M. Smith
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 (
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.