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Poster display

3662 - Serum phosphorylated neurofilament heavy subunit as a predictive marker of chemotherapy-induced cognitive impairment: a preliminary result


10 Oct 2016


Poster display


Kumiko Kida


Annals of Oncology (2016) 27 (6): 15-42. 10.1093/annonc/mdw363


K. Kida1, M. Sumitani2, T. Ogata3, R. Kotake1, A. Natori4, J. Hashimoto5, H. Yamauchi1, T. Yamauchi5

Author affiliations

  • 1 Breast Surgical Oncology, St. Luke's International Hospital, 1048560 - Tokyo/JP
  • 2 Pain And Palliative Medicine, University of Tokyo, Tokyo/JP
  • 3 Center For Sports Sciences And Health Promotion, National Rehabilitation Center for Persons with Disabilities, Tokyo/JP
  • 4 Department Of Medical Oncology And Hematology, Princess Margaret Cancer Centre, Toronto/CA
  • 5 Medical Oncology, St. Luke's International Hospital, 1048560 - Tokyo/JP


Abstract 3662


Chemotherapy-induced cognitive impairments (CICI) have been recognized as a clinically significant problem for cancer survivors, but its assessment method has not been established yet. We previously reported in a cross-sectional study that the serum phosphorylated neurofilament heavy subunit (pNF-H), a biomarker of axonal damage, is increased in breast cancer patients treated with chemotherapy. The aim of this study is to evaluate the association of serum pNF-H level with cognitive functions and brain volume changes after sequential chemotherapy.


Fifteen breast cancer patients who received neoadjuvant or adjuvant chemotherapy underwent cognitive functions tests [Controlled Oral Word Association (COWA), Trail Making Test (TMT), and Hopkins Verbal Learning Test-Revised (HVLT-R)], questionnaires reporting anxiety/depression, and brain MRI, at the baseline period (before chemotherapy) and at one month after finishing the course of chemotherapy (post-period). Serum pNF-H levels were measured at the baseline, every 3 weeks during chemotherapy and at the post-period (9 times in total). Brain MRI volumetry was determined by the BAAD® (Brain Anatomical Analysis using Dartel) software. The correlations between cognitive functions, brain volume, and pNF-H levels [cumulative pNF-H (cumulo-pNF-H), maximum pNF-H (max-pNF-H), pNF-H at 3 weeks after beginning chemotherapy (3wks-pNF-H)] were statistically analyzed.


Patients' median age was 48 years (range 42-73). At baseline, only one patient demonstrated elevated pNF-H level, which was not associated with cognitive functions or brain volumetry. During the course of chemotherapy, pNF-H was elevated in 13 patients. Cumulo-pNF-H, max-pNF-H and 3wks-pNF-H were significantly correlated with cognitive dysfunction on TMT and COWA taken at the post-period. Furthermore, cumulo-pNF-H and max-pNF-H at the post-period were significantly correlated with brain atrophy index and white matter volume loss in some regions.


This preliminary study suggests that serum pNF-H levels of breast cancer patients undergoing chemotherapy can predict CICI and brain atrophy.

Clinical trial identification

Legal entity responsible for the study



Japan agency for medical research and development


All authors have declared no conflicts of interest.

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