The Peripheral Nerve Podcast

In this episode of the Peripheral Nerve Podcast series on inflammatory neuropathies, hosts Professor Hebatallah R Rashed and Dr. Roberto Bellanti welcome Dr. Divyanshu Dubey of Mayo Clinic to discuss paraneoplastic nerve disorders. Dr. Dubey explores the clinical red flags that should raise suspicion for a paraneoplastic neuropathy, including rapidly progressive, painful, asymmetric, or non-length-dependent presentations and accompanying autonomic or central nervous system involvement.

The discussion examines how clinical phenotype, electrophysiology, neural autoantibody testing, and cancer screening work together to support diagnosis, including important considerations when antibody results are low-titer, discordant, or negative. Dr. Dubey also reviews treatment considerations, the importance of early recognition, and the growing complexity of neuropathies associated with immune checkpoint inhibitors and other emerging cancer therapies. Throughout the episode, he emphasizes a central clinical principle: **treat the patient and the phenotype, not the antibody result alone.

After exploring the science of chemotherapy-induced peripheral neuropathy (CIPN) throughout this podcast series, the final episode brings listeners the perspective that matters most—that of someone living with the condition every day.

Professor Susanna Park and Dr. Paola Alberti speak with retired physical therapist Jayne Schak, who developed severe CIPN following treatment for breast cancer. Although cancer-free since 2022, Jayne continues to experience debilitating neuropathic pain that has reshaped her daily life. She shares her personal journey navigating the healthcare system, finding support through the Foundation for Peripheral Neuropathy, and becoming a passionate advocate for patients living with peripheral neuropathy.

The Foundation for Peripheral Neuropathy (FPN)

The Foundation for Peripheral Neuropathy is the leading nonprofit organization dedicated to improving the lives of individuals affected by peripheral neuropathy through awareness, research, advocacy, and education. By connecting patients, caregivers, clinicians, and scientists, FPN advances awareness of peripheral neuropathy and supports access to reliable information and resources. In addition, FPN funds innovative research aimed at better understanding the causes of neuropathy and developing more effective treatments and preventive strategies. The Goal of the Foundation for Peripheral Neuropathy is to one day cure this devastating condition.

Research is essential to addressing chemotherapy-induced peripheral neuropathy (CIPN), one of the most common and debilitating side effects of cancer treatment. Despite its significant impact on quality of life and cancer survivorship, there are currently limited options to prevent or effectively treat CIPN. Research priorities include: (1) identifying the biological mechanisms underlying nerve injury; (2) discovering biomarkers to predict individual risk; (3) developing strategies to prevent neuropathy (without compromising cancer treatment efficacy); and (4) advancing targeted therapies that restore nerve function and reduce symptoms. Continued investment in collaborative, patient-centered research is critical to improving outcomes for cancer survivors living with CIPN.

More information available at https://www.foundationforpn.org/

Jayne Schack, person living with CIPN

Jayne Schack, BS, PT, MA, is a 66 year old retired American physical therapist (PT) [or "physio" as they'd say in most other English-speaking countries]. Living most of her adult working life in Massachusetts, she treated geriatric populations in skilled nursing facilities and home environments, amongst other occupations throughout the years.

Moving to Jonesboro, Arkansas in 2019 to be near her sister, Jayne took a brief foray into academia: first as Assistant Professor in the Department of Physical Therapy at Arkansas State University (AState) in Jonesboro from 2019 to 2021, then as a Standardized Patient for the New York Institute of Technology College of Osteopathic Medicine (NYITCOM) on the AState campus.

Jayne was diagnosed with stage 1A breast cancer in late 2021. The good news is, Jayne has been cancer-free (YAY) since her cancer treatment concluded in July 2022. The bad news: she began having progressively worsening CIPN nerve pain symptoms right around the same time. This was the start of her CIPN journey, the focus of this discussion. As part of this journey, Jayne will discuss her role as a Volunteer Ambassador for The Foundation for Peripheral Neuropathy as well as give feedback for CIPN researchers, oncologists, and other treating clinicians from her perspective as both patient and former "hands-on" clinician.

Although no longer able to work, Jayne has resolved to be a useful member of society through: healthcare advocacy and educating; varied volunteer work; and grassroots community activism. To feed her soul, Jayne enjoys exercise; going to plays, museums, concerts, and movies; spending time with family and friends; participating in her spiritual group; and singing in her choir. Jayne says, "I won't let this nerve pain cause me to be a pimple on the backside of life!" She's proud she was recently able to participate in a Concert Tour Trip to Southern Germany with the AState Choirs.

Chemotherapy-induced peripheral neuropathy (CIPN) is increasingly recognized as more than a direct neurotoxic injury. Emerging research suggests that complex interactions between the nervous system and the immune system play a central role in the development, persistence, and potential recovery from CIPN.

In this episode, Professor Susanna Park and Dr. Paola Alberti welcome Assistant Professor Grace Shin, whose translational research bridges neuroscience, immunology, and dermatology to better understand the biological mechanisms underlying chemotherapy-induced nerve injury. Together they explore the evolving science of neuroimmune crosstalk, discuss how the skin serves as an active neuroimmune organ, and examine how these discoveries may lead to more precise biomarkers and future therapies.

Chemotherapy-induced peripheral neuropathy (CIPN) remains one of the most common and challenging complications of cancer treatment. While significant progress has been made in understanding the condition, measuring treatment success and developing effective therapies continue to present important challenges.

In this episode, Professor Susanna Park and Dr. Paola Alberti welcome Associate Professor Jennifer Gewandter, an internationally recognized expert in pain research, peripheral neuropathy, and clinical trial methodology. Together they explore how researchers evaluate CIPN and examine how clinical trials can better reflect what matters most to patients.

References:

• Ventzel L, Bruna J, Cavaletti G. Concerns About Conclusions of the POLAR Trial. JAMA Oncol. 2025 Sep 1;11(9):1097-1098. doi: 10.1001/jamaoncol.2025.2355. PMID: 40742580.
• https://pnsociety.com/wp-content/uploads/Saab_2025_personalized-outcomes.pdf
• https://pnsociety.com/wp-content/uploads/Gewandter_CIPN-trial-design_Neurology.pdf

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.

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
• Evolution of predictive risk factor analysis for chemotherapy‑related toxicity - https://pnsociety.com/wp-content/uploads/Ep.2-CIDP-Podcast-Paper2-1May2026.pdf

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

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

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.

• 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

Hosts:

• Camila Pupe – Professor of Neurology, Universidade Federal Fluminense, Brazil

• Wilson Marques Jr. – Professor of Neurology, University of São Paulo School of Medicine – Ribeirão Preto

Guests:

• Einar Wilder-Smith – Professor of Neurology, University of Bern, Switzerland

• Pedro Jose Tomaselli – Neurology Department, University of São Paulo, Ribeirão Preto

This episode explores the neurophysiological mechanisms underlying leprosy neuropathy, emphasizing how interactions between Mycobacterium leprae, Schwann cell biology, and host immune responses manifest in electrophysiology. The discussion highlights the distinctive neurophysiological "fingerprint" of leprosy neuropathy and the evolution of diagnostic approaches—from standard nerve conduction studies to multisite protocols and advanced ultrasound techniques.

This episode brings together leading experts in the field, offering rich insights that integrate basic science, clinical neurology, and emerging diagnostic tools.