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Sensory neuropathies are a frequent and dose-limiting complication resulting from treatment with cisplatin. cisplatin; neuropathy Cisplatin is an efficient antineoplastic agent. However, its use is limited by its toxicity. The associated vomiting and nephrotoxicity are currently reduced by the use of antiemetics and vigorous hydration. The most problematic complication of cisplatin treatment is its neurotoxicity in the peripheral nervous system. Cisplatin causes a dosedependent and dose-limiting sensory neuropathy, which is often disabling and from which recovery is often slow and incomplete. 1 Neurotrophin-3 (NT-3) is a promising agent for the prevention and treatment of cisplatininduced neuropathy. Indeed, NT-3 promotes the survival of the large fiber sensory neurones 2 affected in cases of cisplatin-induced neuropathy. 1 Circulating NT-3 can readily reach dorsal root ganglia (DRG), which are the main target of cisplatin toxicity, 3 as there is no bloodnerve barrier. 4 Neurotrophic factors can therefore easily access the large sensory neurones of DRG. Recombinant NT-3 can prevent experimental sensory neuropathies in rats. 5,6 However, the clinical use of recombinant neurotrophic factors is limited by their poor bioavailability after systemic administration: the plasma half-life for NT-3 is only 1.28 min after intravenous administration in the rat. 7 We recently developed a non-viral gene transfer strategy to deliver continuous low doses of NT-3 into the

In this review, we specifically focus on biology and imaging markers. We detail the innovative field of 'omics' approach and imaging and explain their limits to be useful in routine practice. We describe the most relevant biomarkers and suggest some perspectives for biomarker research. Expert commentary: The successive failures of clinical trials in ALS underline the need for new strategy based on innovative tools to stratify patients and to evaluate their responses to treatment. Biomarker data may be useful to improve the designs of clinical trials. Biomarkers are also needed to better investigate disease pathophysiology, to identify new therapeutic targets, and to improve the performance of clinical assessments for diagnosis and prognosis in the clinical setting. A consensus on the best management of neuroimaging and 'omics' methods is necessary and a systematic independent validation of findings may add robustness to future studies.

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