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Second, Carba1 activates nicotinamide phosphoribosyltransferase (NAMPT), enhancing NAD biosynthesis and boosting the metabolic resilience of neurons and Schwann cells against chemotherapy-induced damage. Carba1 shows strong neuroprotective effects in vitro against paclitaxel, cisplatin, and bortezomib toxicity and in vivo in a rat model of paclitaxel-induced neuropathy. Crucially, Carba1 does not interfere with paclitaxel\u2019s tumor-fighting ability or promote tumor growth. Structure-activity analyses of Carba1 derivatives reveal the potential to develop compounds with dual or solely neuroprotective effects. These findings position Carba1 as a promising candidate to prevent CIPN, with potential to enhance both cancer treatment outcomes and patients\u2019 quality of life.<\/jats:p>","DOI":"10.1126\/sciadv.adw6328","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T17:58:36Z","timestamp":1761760716000},"update-policy":"https:\/\/doi.org\/10.34133\/aaas_crossmark","source":"Crossref","is-referenced-by-count":2,"title":["Preventing neuropathy and improving anticancer chemotherapy with a carbazole-based compound"],"prefix":"10.1126","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7242-9541","authenticated-orcid":true,"given":"Lauriane","family":"Bosc","sequence":"first","affiliation":[{"name":"Universit\u00e9 Grenoble Alpes, INSERM U1209, CNRS UMR 5309, Institute for Advanced Biosciences (IAB), 38000 Grenoble, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria 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