Association of Genetic Polymorphisms With Docetaxel-based Chemotherapy Toxicities in Chinese Solid Tumor Patients

Taxanes are one of the most active agents in the treatment of many kinds of solid tumors, mainly including paclitaxel and docetaxel. However, variability in toxicity and response remains a major problem for patients receiving taxanes. It is general that there are many factors for individual differences of drugs in clinical application, of which genetic factors accounted for more than 20%. Toxicities of docetaxel, such as myelosuppression, neurotoxicity or mucositis, were evaluated for possible relationship with pharmacogenetic polymorphisms in several candidate gene and genome-wide association studies. Due to the levels of evidence of those studies are low and lack of sufficient research data of Chinese, it has the important significance in studying individual differences of docetaxel in toxicities, through the pharmacogenomics research.

The aim of this study is to evaluating the association genetic polymorphisms with docetaxel-based chemotherapy toxicities in chinese solid tumor patients. By detecting the gene polymorphism, investigators intend to study the pharmacokinetic/pharmacogenomics (PK-PG) correlation of docetaxel and provide scientific basis for precise medication guide for people to use docetaxel.

Study Overview

• Status: Unknown
• Conditions: Pharmacokinetics; Drug-Related Side Effects and Adverse Reactions; Solid Tumors; Pharmacogenetics; Docetaxel
• Intervention / Treatment: Genetic: detection of genotype

• Study Type: Observational
• Enrollment (Anticipated): 2200

Contacts and Locations

Study Locations

• China
  • Beijing
    • Beijing, Beijing, China, 100034
      • Peking University First Hospital
    • Beijing, Beijing, China, 100142
      • Beijing Cancer Hospital
    • Beijing, Beijing, China, 100171
      • Affiliated Hospital of Academy of Military Medical Sciences
  • Chongqing
    • Chongqing, Chongqing, China, 408000
      • Fuling Center Hospital of Chongqing City
  • Liaoning
    • Shenyang, Liaoning, China, 110001
      • The First Hospital of China Medical University
  • Zhejiang
    • Wenzhou, Zhejiang, China, 325000
      • The First Affiliated Hospital of Wenzhou Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Chinese solid tumor patients with the treatment of docetaxel-based chemotherapy.

Description

Inclusion Criteria:

• Any native Chinese men or women at least 18 years of age;
• Sign informed consent of the research;
• Have a histologic or cytologic diagnosis of solid tumor;
• Will receive docetaxel-based chemotherapy; Or patients who received docetaxel chemotherapy meet the inclusion and exclusion criteria of the research, and their clinical information is complete to obtain;
• Male and female patients with reproductive potential must use an approved contraceptive method during and for 3 months after discontinuation of study treatment. Women with childbearing potential must have a negative pregnancy test within 7 days prior to study enrollment;
• Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.
• Have discontinued all previous therapies for cancer for at least 28 days prior to study entry, and have recovered from the acute effects of therapy.

• Have adequate organ function, including:

  1. Bone marrow reserve:

     1. ANC≥1.5×109/L
     2. PLT≥100×109/L
     3. HGB≥10g/dL

  2. Hepatic:

     1. Bilirubin ≤ 1.5ULN
     2. ALT, AST ≤2.5 ULN, ≤5ULN when liver metastases are known
  3. Renal: Src ≤1.5mg/dl
• Electrolytes: Patients may be entered into the study if, in the investigators' opinion, any electrolyte disorders, including K<3.4mEq/L, Ca<8.4mEq/L, or Mg<1.2mEq/L, may be appropriately managed and stabilized by the time of the laboratory evaluation prior to the chemotherapy. If electrolytes have not been stabilized during this time, the patient will be discontinued from the study.
• Have an estimated life expectancy, in the judgment of the investigator, which will permit the patient to complete the PK phase and at least 2 cycle of the evaluation of the toxicities.

Exclusion Criteria;

• Serious concomitant systemic disorder, including active infection, which is incompatible with the study (at the discretion of the investigator).
• History of human immunodeficiency virus, hepatitis B, or hepatitis C infections.
• Cardiac: Have a serious cardiac condition, such as myocardial infarction within 6 months, angina, or heart disease, as defined by the New York Heart Association Class III or IV. It is recommended that patients with arrhythmias (persistent or paroxysmal ventricular or supraventricular arrhythmias, including atrial fibrillation or bradycardia (heart rate <50 beats per minute))be excluded at the investigator's discretion.
• Known family history of unexplained sudden death.
• Personal history of unexplained syncope within the last year.
• Women who are breast feeding, lactating, or pregnant.
• Patients with known allergies to docetaxel and its supplementary materials.
• Drugs and herbal supplements that are known to be potent or moderate inhibitors or inducers of cytochrome P450 (CYP)3A4 are specifically excluded. Foods that are known to be potent or moderate inhibitors of CYP3A4 are also specifically excluded during the study.
• Patients receiving herbal regimens.
• Use of drugs with narrow therapeutic windows that are also known substrates of CYP3A4.
• Failure for any reason to satisfy the investigator for adequate fitness to participated in the study.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
wild genotype; Through next generation sequencing, distinguish wild genotype of docetaxel	Genetic: detection of genotype; detection of genotype by next generation sequencing
mutant genotype; Through next generation sequencing, distinguish mutant genotype of docetaxel	Genetic: detection of genotype; detection of genotype by next generation sequencing

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of severe hematological toxicity	The toxicity induced by docetaxel-based chemotherapy during observation time will be estimated on the basis of the National Cancer Institute Common Toxicity Criteria Version 4.03. Patients with grade 3-4 adverse events will be considered as having severe toxicity. At the end of each cycle (each cycle is 21 days) the grade will be scored. And the severest grade will be recorded and used for analysis. Hematological toxicity includes neutropenia, leukopenia, anemia and thrombocytopenia.	At 1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Genotyping	Collect blood specimen, then detect genotype by next generation sequencing.	Before chemotherapy
Incidence of other severe toxicities	The other toxicities induced by docetaxel-based chemotherapy during observation time, including gastrointestinal toxicity, neurotoxicity etc., will be estimated on the basis of the National Cancer Institute Common Toxicity Criteria Version 4.03. Toxicities with grade 3-4 will be considered as severe toxicity, except for severe neurotoxicity (grade 2-3). At the end of each cycle (each cycle is 21 days) the grade will be scored. And the severest grade will be recorded and used for analysis.	At 1 year
The kinds of the metabolites	Determine the metabolic profiles of docetaxel. This outcome is not applicable to patients retrospectively collected.	Pre-dose and 6 hours post-dose in the first cycle
Area under the curve [AUC]	Determine the AUC of docetaxel and its metabolites. This outcome is not applicable to patients retrospectively collected.	Pre-dose and 6 hours post-dose in the first cycle

Collaborators and Investigators

• Sponsor: Cui Yimin

Study record dates

Study Major Dates

• Study Start (Actual): September 25, 2017
• Primary Completion (Anticipated): September 1, 2019
• Study Completion (Anticipated): December 1, 2019

Study Registration Dates

• First Submitted: August 16, 2017
• First Submitted That Met QC Criteria: August 18, 2017
• First Posted (Actual): August 23, 2017

Study Record Updates

• Last Update Posted (Actual): August 28, 2019
• Last Update Submitted That Met QC Criteria: August 27, 2019
• Last Verified: August 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Chemically-Induced Disorders; Drug-Related Side Effects and Adverse Reactions
• Other Study ID Numbers: 2016[1239]-2

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No