Assessment of chemotherapy‐induced neurotoxicity using a point‐of‐care nerve conduction study device

BACKGROUND: Management for chemotherapy‐induced peripheral neuropathy (CIPN) includes prompt recognition and dose reduction or discontinuation of the neurotoxic agents. CIPN remains under‐detected in routine clinical practice and better methods for its early detection are warranted. AIMS: To evaluate the feasibility of a point‐of‐care device in the early detection of CIPN. METHODS AND RESULTS: Cancer patients (n = 12) scheduled to receive neurotoxic chemotherapy docetaxel, oxaliplatin (OX), or vincristine were recruited for the pilot study (NCT04778878). The patients were assessed with a point‐of‐care nerve conduction study device (Mediracer® NCS), EORTC QLQ‐CIPN20 and NPSI questionnaires, and healthcare professional‐assessed CTCAE‐based grading at baseline and thereafter every 6‐weeks up to 18 weeks or until chemotherapy discontinuation. The set‐up of point‐of‐care device was easy but it only provide successful NCS measurement results in 55% of the patients. The factors related to failed measurement were older age, more frequent comorbidities, and a history of smoking. With the follow‐up measurements, decreasing median nerve mean conduction velocity and amplitude, and increasing median nerve mean distal latency were detected on OX‐patients. Of the used questionnaires, NPSI was found to be non‐feasible with majority of the patients failing to complete the questionnaire while CIPN20 was feasible on all the subjects. CIPN20 score did not show any changes in the follow‐up. CONCLUSIONS: Point‐of‐care assessment for NCS was feasible but measurements frequently failed especially on patients with pre‐existing high‐risk for neuropathy. OX‐treated showed decreasing NCS results while other measures were unable to access the change. The system should be further validated with a larger patient cohort preferably treated with OX and low‐risk for pre‐existing neuropathy.