A Correlative Blood Assay to Monitor Patients at Risk for Chemotherapy-Induced Peripheral Neuropathy

Philadelphia, PA

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a disabling side effect of platinum-based chemotherapies like cis-, oxali- and carboplatin. While not all patients experience this effect, those that do are at risk for lifelong neuropathy. Platinum-based therapies cause bursts of reactive oxygen species (ROS), which can trigger structural changes in peripheral nerves including neuronopathy, axonopathy and/or myelinopathy. Glutathione, an antioxidant, plays an important role in redox homeostasis. The recycling of glutathione can be determined by the ChemoTox assay and the aim of this study was to examine its ability to predict CIPN.

Methods: Blood drawn from consented and chemotherapy naïve patients (N= 59) were tested for glutathione recycling capacity and normalized to total red cell numbers. At each session patients reported outcomes, including neuropathy, using the Rotterdam Symptom Check List. Patient’s glutathione recycling capacities were correlated to self-reported neuropathy.

Results: 42 patients experienced neuropathy and 21 reported neuropathy at ≥2 (Rotterdam 0-3) for an extended period of time during their treatment. This preliminary study showed an inverse correlation between ChemoTox and CIPN; in combining this data with a clinical vignette, the test proved efficacious in at risk patients.

Conclusions: This assay might be a tool for physicians to identify patient’s relative risk over the course of treatment to avoid permanent neuropathy.