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Serum neurofilament light chain levels as biomarker of paclitaxel-induced cognitive impairment in patients with breast cancer: a prospective study

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Abstract

Objective

To prospectively assess the utility of serum neurofilament light chain (sNfL) levels in identifying the risk to develop chemotherapy-induced cognitive impairment (CICI) in cancer patients. We also examined if sNfL can be identified as an early biomarker of CICI development.

Methods

We longitudinally measured sNfL levels in 20 female patients with breast cancer, scheduled to receive the 12 weekly paclitaxel-based regimen. An equal number of age-matched female heathy subjects was incuded as control group. CICI was graded by means of the Montreal Cognitive Assessment scale (MOCA); peripheral neurotoxicity (PN) was graded using the neurosensory Common Criteria for Adverse Events (CTCAE)v5.0, while sNfL levels were quantified using a high-sensitive technique (Quanterix, Simoa) before the administration of chemotherapy (T0), after 3 courses (T1), and at the end of chemotherapy (T2).

Results

Pre-treatment sNfL levels were comparable in patients and controls (p = 0.103). At T2, 5/20 patients (mean age 61.4 ± 5.0 years) developed CICI. These 5 patients also had clinically-significant PN. Patients with and without CICI had comparable sNfL values at T2 (p = 0.1). In addition, at T2, sNfL levels did not correlate significantly with MOCA score in CICI patients (p = 0.604). The difference of sNfL levels between T1 and T0 failed to predict independently the occurrence of CICI at T2.

Conclusion

Our findings do not support the utility of measuring sNfL levels as a biomarker of CICI. Grade 2–3 PN most strongly confounded our outcomes. Considering the small sample size, which might have prevented the results from being extrapolated, further testing in larger studies is warranted.

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Data availability

The corresponding author has full control of all primary data and agrees to allow the journal to review our data if requested.

Code availability

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Funding

M.S. has received support from the Instituto de Salud Carlos III, through the project PI18/01253 (co-funded by the European Regional Development FUND-ERDF, a way to build Europe).

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Author notes

  1. Andreas A. Argyriou and Sofia Karteri contributed equally to this work.

Authors and Affiliations

  1. Neurology Department, Saint Andrew’s General Hospital of Patras, Patras, Greece

    Andreas A. Argyriou & Haralabos P. Kalofonos

  2. Oncology Unit, Department of Internal Medicine, University Hospital of Patras, Patras, Greece

    Sofia Karteri

  3. Neuro-Oncology Unit, Hospital Universitari de Bellvitge-ICO L’Hospitalet (IDIBELL), Barcelona, Spain

    Jordi Bruna & Marta Simo

  4. Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy

    Sara Mariotto & Sergio Ferrari

  5. Department of Internal Medicine, University Hospital of Patras, Patras, Greece

    Dimitrios Velissaris

  6. Department of Oncology, Imperial NHS Healthcare Trust, Charing Cross Hospital, London, UK

    Foteini Kalofonou

  7. Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy

    Guido Cavaletti

  8. Department of Medicine, Division of Oncology, University Hospital, University of Patras Medical School, 26504, Rion-Patras, Greece

    Haralabos P. Kalofonos

Authors
  1. Andreas A. Argyriou
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Contributions

All authors whose names appear on the submission made substantial contributions to the conception or design of the work; the acquisition, analysis, or interpretation of data; drafted the work; approved the version to be published. The corresponding author agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Haralabos P. Kalofonos.

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Argyriou, A.A., Karteri, S., Bruna, J. et al. Serum neurofilament light chain levels as biomarker of paclitaxel-induced cognitive impairment in patients with breast cancer: a prospective study. Support Care Cancer 30, 1807–1814 (2022). https://doi.org/10.1007/s00520-021-06509-x

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