Neurofilament light chain as a biomarker of chemotherapy-induced peripheral neuropathy.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and dose-limiting side effect of chemotherapy. CIPN is difficult to grade objectively, and therefore efforts have been aimed at identifying an objective biomarker of CIPN. During the past 4 years, neurofilament light chain (NFL) has emerged as a preclinical and clinical biomarker of CIPN. Several chemotherapeutics cause rapid and dramatic increases in NFL levels in in vitro systems, rodent models, and clinical studies, which indicates that NFL reflects neuronal damage. Thus far, paclitaxel appears to cause the most pronounced increases. Early elevations in serum NFL may predict later occurrence of CIPN in cancer patients. NFL shows promise as an objective biomarker of CIPN especially in in vitro and in rodent models. The prognostic value of NFL to predict CIPN is still not established and requires prospective evaluation. Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy. The frequency of CIPN ranges from one in three to almost all patients depending on type of chemotherapy and dose. It causes symptoms that can range from sensitivity to touch and numbness to neuropathic pain in hands and feet. CIPN is notoriously difficult to grade objectively and has mostly relied on a clinician- or patient-based rating that is subjective and poorly reproducible. Thus, considerable effort has been aimed at identifying objective biomarkers of CIPN. Recent in vitro , animal, and clinical studies suggest that neurofilament light chain (NFL), a structural neuronal protein, may be an objective biomarker of CIPN. NFL released from cells to cell culture media reflects in vitro neurotoxicity, while NFL in serum reflects neuronal damage caused by chemotherapy in rodent models. Finally, NFL in serum may be a diagnostic biomarker of CIPN, but its prognostic ability to predict CIPN requires prospective evaluation. We discuss current limitations and future perspectives on the use of NFL as a preclinical and clinical biomarker of CIPN. [ABSTRACT FROM AUTHOR]