化疗引起的周围神经毒性（CIPN）的实时生物标志物将有助于治疗期间的临床决策。当神经轴突损伤时，可以在血液中检测到神经丝轻链 (NfL)。该研究的目的是根据化疗药物的类型和 CIPN 的严重程度比较血浆 NfL (pNfL) 水平。这项单中心前瞻性观察性纵向研究包括接受紫杉醇治疗的患者 (TX; n = 34)， brentuximab vedotin (BV; n = 29) 或奥沙利铂 (PT; n = 19)。所有患者在治疗前、治疗期间以及治疗结束后 6-12 个月内均使用总神经病变评分临床版本和不良事件通用术语标准进行评估。在化疗停止之前和之后进行神经传导研究（NCS）。使用 Simoa® 分析仪分析连续血浆样本的 NfL 水平。比较各组之间 pNfL 的变化，并最终与临床和 NCS 数据相关。临床相关（CR）CIPN 被认为是 ≥ 2 级。纳入82 名患者，其中大多数是女性（59.8%）。接受 TX (29.4%)、BV (31%) 或 PT (36.8%) 治疗的患者分别有三分之一发展为 CR-CIPN，三者之间无差异 (p = 0.854)。尽管所有三组的 pNfL 在治疗期间显着增加，并在整个恢复期间下降，但与其他药物相比，接受 TX 的患者的 pNfL 水平显示出显着更大且更早的变化 (p < 0.001)。具有可比 CIPN 严重程度的药剂类型和神经毒性机制，强烈暗示需要为每种药剂确定不同的截止值。© 2024 作者。约翰·威利出版的《欧洲神经病学杂志》

A real-time biomarker in chemotherapy-induced peripheral neurotoxicity (CIPN) would be useful for clinical decision-making during treatment. Neurofilament light chain (NfL) can be detected in blood in the case of neuroaxonal damage. The aim of the study was to compare the levels of plasma NfL (pNfL) according to the type of chemotherapeutic agent and the severity of CIPN.This single-center prospective observational longitudinal study included patients treated with paclitaxel (TX; n = 34), brentuximab vedotin (BV; n = 29), or oxaliplatin (PT; n = 19). All patients were assessed using the Total Neuropathy Score-clinical version and Common Terminology Criteria for Adverse Events before, during, and up to 6-12 months after the end of treatment. Nerve conduction studies (NCS) were performed before and after chemotherapy discontinuation. Consecutive plasma samples were analyzed for NfL levels using a Simoa® analyzer. Changes in pNfL were compared between groups and were eventually correlated with clinical and NCS data. Clinically relevant (CR) CIPN was considered to be grade ≥ 2.Eighty-two patients, mostly women (59.8%), were included. One third of the patients who received TX (29.4%), BV (31%), or PT (36.8%) developed CR-CIPN, respectively, without differences among them (p = 0.854). Although pNfL significantly increased during treatment and decreased throughout the recovery period in all three groups, patients receiving TX showed significantly greater and earlier changes in pNfL levels compared to the other agents (p < 0.001).A variable change in pNfL is observed depending on the type of agent and mechanism of neurotoxicity with comparable CIPN severity, strongly implying the need to identify different cutoff values for each agent.© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.