Abstract
We set out to determine the usability of serum neurofilament light chain (sNfL), serum glial fibrillary acidic protein (sGFAP), and retinal parameters by using optical coherence tomography (OCT) as reliable biomarkers of the progression of oxaliplatin-induced peripheral neuropathy (OIPN). Forty-three patients scheduled to undergo oxaliplatin-based chemotherapy at the National Cancer Center of Korea between June 2018 and October 2019 were prospectively assessed at baseline, 3 months, and 6 months of chemotherapy. Patients were assessed on clinical scales and underwent OCT, sNfL, and sGFAP level measurement at each follow-up visit. By applying the National Cancer Institute-Common Toxicity Criteria (NCI-CTC), OIPN was classified as grade 1 in 12 (28%) patients, grade 2 in 25 (58%), and grade 3 in 5 (12%) at 6 months of chemotherapy. sNfL levels increased during oxaliplatin administration, while serial sGFAP levels or retinal parameters did not change. Patients with grade-3 OIPN showed significantly higher mean sNfL levels than patients with grade 0–2 OIPN at 6 months of treatment. At 4–6 months after completion of chemotherapy, sNfL levels were significantly reduced compared to the levels at 6 months of chemotherapy. Monitoring of sNfL during chemotherapy can indicate ongoing neuroaxonal injury and the severity of OIPN.
Highlights
We set out to determine the usability of serum neurofilament light chain, serum glial fibrillary acidic protein, and retinal parameters by using optical coherence tomography (OCT) as reliable biomarkers of the progression of oxaliplatin-induced peripheral neuropathy (OIPN)
The emergence of the single molecule arrays (SIMOA), an ultra-sensitive enzyme-linked immunosorbent assay (ELISA) technique, for measuring Neurofilament light chain (NfL) and Glial fibrillary acidic protein (GFAP) levels in peripheral blood has led to the renaissance of NfL and GFAP as biomarkers in several diseases characterized by axonal loss in the central nervous system and peripheral nervous system, including multiple sclerosis, stroke, head injury, dementia, and immune-mediated neuropathy[9,11]
We set out to determine the usability of serum NfL, GFAP, and retinal nerve fibre layer (RNFL) as reliable and accessible biomarkers of the progression and severity of chronic oxaliplatin-induced peripheral neuropathy (OIPN)
Summary
We set out to determine the usability of serum neurofilament light chain (sNfL), serum glial fibrillary acidic protein (sGFAP), and retinal parameters by using optical coherence tomography (OCT) as reliable biomarkers of the progression of oxaliplatin-induced peripheral neuropathy (OIPN). The assessment of CIPN usually depends on the patient’s symptoms that are judged according to physician evaluation scores such as the National Cancer Institute-Common Toxicity Criteria (NCI-CTC), which show poor sensitivity to change and low interrater reliability[5]. Because clinical assessments of CIPN usually depend on the patient’s subjective evaluation of their symptoms, objective and quantitative measures are fundamental. We set out to determine the usability of serum NfL (sNfL), GFAP (sGFAP), and RNFL as reliable and accessible biomarkers of the progression and severity of chronic oxaliplatin-induced peripheral neuropathy (OIPN)
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