Neurotoxicity and Chemotherapy - An Oncology Perspective

Precision Medicine: Biomarkers and Risk Prediction in Chemotherapy Induced Peripheral Neuropathy

Why do some patients develop severe chemotherapy-induced peripheral neuropathy (CIPN) while others receiving the same treatment experience little or no nerve damage? In this episode, Drs. Paola Alberti and Susanna Park welcome Professor Roser Velasco, neurologist, neuro-oncology researcher, and internationally recognized expert in treatment-related neurotoxicity. The discussion explores the rapidly evolving field of precision medicine in CIPN, with a focus on biomarkers that may help predict risk, monitor nerve injury, and support personalized treatment strategies. Professor Velasco reviews the current state of biomarker research, including clinical risk factors, neurophysiological testing, blood-based biomarkers such as neurofilament light chain (NfL), imaging approaches, and emerging multimodal prediction models designed to identify patients at greatest risk for long-term neuropathy. References & Resources: * Plasma neurofilament light chain levels in chemotherapy-induced peripheral neurotoxicity according to type of anticancer drug. Velasco R, Marco C, Domingo-Domenech E, Stradella A, Santos C, Laquente B, Ferrer G, Argyriou AA, Bruna J. Eur J Neurol. 2024 Sep;31(9):e16369. * Serum neurofilament levels correlate with electrodiagnostic evidence of axonal loss in paclitaxel-induced peripheral neurotoxicity. Velasco R, Argyriou AA, Marco C, Mariotto S, Stradella A, Hernández J, Pernas S, Ferrari S, Bruna J. J Neurol. 2023 Jan;270(1):531-537. * Prospectively assessing serum neurofilament light chain levels as a biomarker of paclitaxel-induced peripheral neurotoxicity in breast cancer patients. Karteri S, Bruna J, Argyriou AA, Mariotto S, Velasco R, Alemany M, Kalofonou F, Alberti P, Dinoto A, Velissaris D, Stradella A, Cavaletti G, Ferrari S, Kalofonos HP. J Peripher Nerv Syst. 2022 Jun;27(2):166-174. * Serum neurofilament light chain (sNFL) as a predictive biomarker for Chemotherapy-induced peripheral neurotoxicity (CIPN): consideration of current evidence, validation steps, and barriers to CIPN biomarker implementation in clinical practice-a narrative review. Alberti P, Faithfull S, Argyriou AA, Balayssac D, Hertz DL, Lustberg M, Park SB, Li T, Tanay M, Jabaley T, Worthen-Chaudhari L, Smith EML; MASCC Neurological complications study group. Support Care Cancer. 2026 May 7;34(6):508. * Sarcopenia in Patients With Cancer and Its Association With Chemotherapy-Induced Peripheral Neurotoxicity. Velasco R, Besora S, Bellver M, Peiró I, Marco C, Domingo-Domenech E, Santos C, Stradella A, Laquente B, Rodriguez S, Argyriou AA, Arribas L, Bruna J. Neurology. 2026 May 26;106(10):e214987. * Incidence and risk factors for developing chemotherapy-induced neuropathic pain in 500 cancer patients: A file-based observational study. Argyriou AA, Bruna J, Kalofonou F, Velasco R, Litsardopoulos P, Alemany M, Anastopoulou GG, Kalofonos HP. J Peripher Nerv Syst. 2024 Mar;29(1):38-46. * Chemotherapy-induced peripheral neurotoxicity: management informed by pharmacogenetics. Argyriou AA, Bruna J, Genazzani AA, Cavaletti G. Nat Rev Neurol. 2017 Aug;13(8):492-504. * Plasma Lipidomic Profiling Identifies Elevated Triglycerides as Potential Risk Factor in Chemotherapy-Induced Peripheral Neuropathy. Yeung N, Li T, Lin HM, Timmins HC, Goldstein D, Harrison M, Friedlander M, Mahon KL, Giles C, Meikle PJ, Park SB, Horvath LG. JCO Precis Oncol. 2024 Apr;8:e2300690. * Predictive Biomarkers of Oxaliplatin-Induced Peripheral Neurotoxicity. Velasco R, Alemany M, Villagrán M, Argyriou AA. J Pers Med. 2021 Jul 16;11(7):669.

Neurotoxicity and Chemotherapy - An Oncology Perspective

In this episode of the Peripheral Nerve Podcast, hosts Susanna Park and Paola Alberti are joined by Maryam Lustberg to explore the real-world impact of chemotherapy-induced peripheral neuropathy (CIPN). Together, they examine why CIPN remains such a persistent challenge in oncology care and discuss evolving approaches to assessment, management, and research. The conversation also looks ahead to emerging innovations and the growing importance of collaborative, patient-centered care. Resources: * Mitigating long-term and delayed adverse events associated with cancer treatment: implications for survivorship - https://pnsociety.com/wp-content/uploads/Ep.2-CIDP-Paper1-1May2026.pdf [https://pnsociety.com/wp-content/uploads/Ep.2-CIDP-Paper1-1May2026.pdf] * Evolution of predictive risk factor analysis for chemotherapy‑related toxicity - https://pnsociety.com/wp-content/uploads/Ep.2-CIDP-Podcast-Paper2-1May2026.pdf [https://pnsociety.com/wp-content/uploads/Ep.2-CIDP-Podcast-Paper2-1May2026.pdf]

Cellular and Molecular Mechanisms of Chemotherapy Induced Peripheral Neuropathy Pathophysiology

In this episode of the Peripheral Nerve Podcast, hosts Dr. Paola Alberti (University of Milano-Bicocca, Italy) and Professor Susanna Park (University of Sydney, Australia) are joined by Professor Guido Cavaletti (University of Milano-Bicocca, Italy), a global leader in chemotherapy-induced peripheral neuropathy (CIPN) research. This discussion explores the current understanding and ongoing uncertainties surrounding the cellular and molecular mechanisms that drive CIPN. Drawing on decades of research, Professor Cavaletti provides critical insights into pathophysiology, translational challenges, and emerging therapeutic strategies. Links for show notes: journals.lww.com/pain/fulltext/2024/11000/translation_of_paclitaxel_induced_peripheral.11.aspx Transcript: https://pnsociety.com/wp-content/uploads/Ep1-CIPN-Podcast-Transcript-23March2026.docx

Treatment, Prognosis, Prevention

In this concluding episode of the Peripheral Nerve Society's Leprosy Awareness Podcast series, global experts examine the critical reality that microbiologic cure does not equal patient recovery. The discussion focuses on practical, real-world priorities: * Treating Hansen's disease effectively * Predicting neurologic and functional outcomes * Preventing disability, stigma, and ongoing transmission The panel emphasizes that while multidrug therapy (MDT) reliably cures infection, nerve damage, disability, and social consequences remain the central unmet needs in leprosy care. Transcript: https://pnsociety.com/wp-content/uploads/PNS-Podcast_Ep7_Treatment-and-prognosis-of-leprosy-neuropathy_19Feb2026.pdf [https://pnsociety.com/wp-content/uploads/PNS-Podcast_Ep7_Treatment-and-prognosis-of-leprosy-neuropathy_19Feb2026.pdf]

Pathology and imaging methods in leprosy neuropathy

In this episode of the Leprosy Awareness Podcast, we tackle one of the most complex challenges in clinical practice: accurate and timely diagnosis of leprosy neuropathy. This episode explores how neurologists, dermatologists, and imaging specialists can integrate clinical examination, neurophysiology, ultrasound, Doppler, elastography, and MRI neurography to improve diagnostic accuracy—while minimizing misdiagnosis and false positives. Through expert discussion, we examine leprosy as a spectral neuroinflammatory disease, the limitations of single-modality testing, and the importance of multidisciplinary collaboration in both endemic and non-endemic settings. Featured Guests * Prof. Marcello Nogueira-Barbosa, MD, PhD Associate Professor of Radiology, University of São Paulo - Ribeirão Preto, Brazil * Prof. Diogo Fernandes dos Santos, MD, PhD Associate Professor of Neurology, Universidade Federal de Uberlândia, Brazil