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. 2025 Mar 14;17(6):988.
doi: 10.3390/cancers17060988.

Neurofilaments as Prognostic Biomarkers in the Assessment of the Risk of Advanced Taxane-Induced Neuropathy in Breast Cancer Patients-A Pilot Study

Agata Makówka  1 , Malgorzata Fuksiewicz  1 , Anna Bałata  2 , Anna Borowiec  3 , Katarzyna Pogoda  2 , Zbigniew Nowecki  2 , Agnieszka Jagiello-Gruszfeld  4 , Beata Janas  5 , Beata Kotowicz  1
Affiliations

Neurofilaments as Prognostic Biomarkers in the Assessment of the Risk of Advanced Taxane-Induced Neuropathy in Breast Cancer Patients-A Pilot Study

Agata Makówka et al. Cancers (Basel). .

Abstract

Objectives: The aim of the present study was to assess the clinical value of measuring the concentration of neurofilament light chains (NF-Ls) in the diagnosis of taxane-induced neuropathy (CIPN) during neoadjuvant chemotherapy (NAC) in breast cancer patients.

Methods: This study included a total of 94 patients who qualified for NAC with taxanes. Serum samples were collected before starting NAC, after three and six cycles, and 3-6 months after NAC. The NF-L concentration was determined using the Ella technology. The assessment of CIPN was based on the clinical symptoms included in the EORTC QLQ-CIPN20 scores.

Results: The median NF-L concentrations increased during NAT monitoring. After the end of therapy, a significant decrease in NF-L concentrations was observed (p = 0.001, R = 0.37). We established a cut-off point of 29.5 pg/mL to distinguish between the control group and patients with early symptoms of neuropathy (CIPN G1) (p = 0.001; AUC = 0.982). We showed that NF-L concentrations, regardless of the stage of therapy, increased with the severity of neuropathy symptoms (CIPG1 vs. G2 vs. G3) (p = 0.0189, R = 0.33). According to the established cut-off points, serum NF-L concentrations above 196 pg/mL in patients undergoing therapy likely indicate the presence of low-grade neuropathy (p = 0.0076), while values above 218 pg/mL may indicate advanced CIPN (p = 0.0008).

Conclusions: In this study, we demonstrated the usefulness of NF-L levels to confirm neuropathy early in the course of treatment, which is important as the questionnaire-based assessment of neuropathy currently used in practice remains subjective. Ultimately, serum NF-L levels are helpful in determining the severity of NAC-induced neuropathy among breast cancer patients.

Keywords: NF-L; biomarker; breast cancer; neuropathy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Ranges and median NF-L concentrations before treatment (1), after 3 weekly cycles (2), after 6 cycles (3), and 3–6 months after completion of NAC (4) in breast cancer patients.
Figure 2
Figure 2
ROC curve for NF-L concentrations in the control group compared to concentrations in breast cancer patients with CIPN G1.
Figure 3
Figure 3
ROC curve for NF-L levels in breast cancer patients without neuropathy, CIPN G0 vs. patients with CIPN G1.
Figure 4
Figure 4
ROC curve for NF-L levels in patients with CIPN G0 vs. patients with CIPN G2 and CIPN G3.
Figure 5
Figure 5
NF-L concentration ranges and medians in patients treated with NAC with paclitaxel without symptoms of neuropathy, CIPN G0 vs. CIPN G1.
Figure 6
Figure 6
NF-L concentration ranges and medians in patients treated with NAC with taxanes in CIPN grades: CIPN G1 vs. CIPN G2 vs. CIPN G3.
See this image and copyright information in PMC

References

    1. Abu Samaan T.M., Samec M., Liskova A., Kubatka P., Büsselberg D. Paclitaxel’s Mechanistic and Clinical Effects on Breast Cancer. Biomolecules. 2019;9:789. doi: 10.3390/biom9120789. - DOI - PMC - PubMed
    1. Brewer J.R., Morrison G., Dolan M.E., Fleming G.F. Chemotherapy-induced peripheral neuropathy: Current status and progress. Gynecol. Oncol. 2016;140:176–183. doi: 10.1016/j.ygyno.2015.11.011. - DOI - PMC - PubMed
    1. Inoue M., Matsumoto K., Tanaka M., Yoshida Y., Satake R., Goto F., Shimada K., Mukai R., Hasegawa S., Suzuki T., et al. Analysis of chemotherapy-induced peripheral neuropathy using the Japanese Adverse Drug Event Report database. Sci. Rep. 2021;11:11324. doi: 10.1038/s41598-021-90848-6. - DOI - PMC - PubMed
    1. Burgess J., Ferdousi M., Gosal D., Boon C., Matsumoto K., Marshall A., Mak T., Marshall A., Frank B., Malik R.A., et al. Chemotherapy-Induced Peripheral Neuropathy: Epidemiology, Pathomechanisms and Treatment. Oncol. Ther. 2021;9:385–450. doi: 10.1007/s40487-021-00168-y. - DOI - PMC - PubMed
    1. Schroyen G., Blommaert J., van Weehaeghe D., Sleurs C., Vandenbulcke M., Dedoncker N., Hatse S., Goris A., Koole M., Smeets A., et al. Neuroinflammation and Its Association with Cognition, Neuronal Markers and Peripheral Inflammation after Chemotherapy for Breast Cancer. Cancers. 2021;13:4198. doi: 10.3390/cancers13164198. Erratum in Cancers 2023, 15, 3091. - DOI - PMC - PubMed

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