Neurofilament Light Chain (NfL) as A Potential Biomarker of Chemotherapy-Induced Peripheral Neuropathy (CIPN) in Cervical Cancer Patients

Chemotherapy-Induced Peripheral Neuropathy (CIPN) is a complication of chemotherapy observed in several types of cancer, including cervical cancer. The pathomechanism of CIPN is multifactorial and depends on the type and dosage of chemotherapy administered. CIPN is an axonopathy that can lead to clinical manifestations of polyneuropathy. Proper diagnosis, management, and dose adjustments are necessary to prevent permanent nerve damage. However, no gold standard diagnostic test for CIPN currently exists. One biomarker that has recently gained attention is the neurofilament light chain (NfL). NfL is the most abundant filament in neurons and axons, playing a crucial role in the assembly and maintenance of the axonal cytoskeleton. Disruption of the axonal membrane results in the release of neurofilaments into the interstitial fluid, which subsequently enters the cerebrospinal fluid (CSF) and blood serum. Due to its lowest molecular weight and highest solubility among neurofilaments, NfL diffuses more readily from the parenchyma into the CSF following axonal degeneration, neuronal death, or neuronal damage. Therefore, elevated NfL concentrations in the blood serum serve as a marker of axonal degeneration. The potential role of NfL as a biomarker for neurologists should be a point of interest, which may aid in the clinical diagnosis of CIPN in the future.