A New Scoring System Administered by Patients to Identify Moderate-to-Severe Chemotherapy-Induced Peripheral Neuropathy: Final Results of the NEURO-BREAC Trial

Background/Objectives: Many breast cancer patients treated with taxanes experience chemotherapy-induced peripheral neuropathy (CIPN). The early detection of CIPN may be facilitated by scoring systems. The existing Utah Early Neuropathy Scale (UENS) requires the presence of medical staff members. A self-assessment tool usable by patients is desired. Such an instrument was recently developed but had not yet been evaluated for the detection of CIPN. This prospective study aimed to identify the optimal cut-off score for the identification of moderate-to-severe CIPN in breast cancer survivors. Methods: Twenty-six breast cancer survivors (patients) who previously received taxane-based chemotherapy were included. Eighteen patients presenting with moderate-to-severe CIPN and eight patients without CIPN used the new scoring system (0-44 points). For each cut-off score, sensitivity, specificity, Youden index, and positive (PPV) and negative (NPV) predictive values were calculated. Patients rated their satisfaction with the tool. Dissatisfaction rates of >20% and >40%, respectively, would mean that it needed optimization or could not be used. Afterwards, the UENS (0-42 points) was applied by medical staff members. Results: For the new tool, a cut-off score of 9 points was found to be optimal for identifying moderate-to-severe CIPN. The sensitivity, specificity, Youden index, and PPV and NPV were 100% in each case. The dissatisfaction rate was 7.7%. When applying the UENS, the sensitivity, specificity, Youden index, and PPV and NPV were each 100% for a cut-off score of 6 points. Conclusions: The new self-assessment scoring system was highly accurate regarding the identification of moderate-to-severe CIPN. Patient satisfaction was high. When considering the limitations of this trial, the new instrument may be used in future studies.