Pharmacoethnicity of docetaxel-induced severe neutropenia: integrated analysis of published phase II and III trials

Int J Clin Oncol. 2013 Feb;18(1):96-104. doi: 10.1007/s10147-011-0349-5. Epub 2011 Nov 18.

Abstract

Background: Ethnic differences in drug susceptibility and toxicity are a major concern, not only in drug development but also in the clinical setting. We review the toxicity profiles of docetaxel according to dose and ethnicity.

Methods: We analyzed phase II and III clinical trials that included a once-every-3-weeks single-agent docetaxel arm. Logistic regression analysis was applied to identify the significant variables affecting the reported incidence of docetaxel-induced severe neutropenia.

Results: Multivariate logistic regression analysis identified studies conducted in Asia [odds ratio (OR) 19.0; 95% confidence interval (95% CI) 3.64-99.0] and docetaxel dose (OR 1.08; 95% CI 1.03-1.13) as independent variables for the incidence of grade 3/4 neutropenia.

Conclusions: There is a significant difference in the incidence of docetaxel-induced severe neutropenia between Asian and non-Asian clinical studies. Physicians and pharmacists should consider ethnic diversity in docetaxel toxicity when interpreting the results of clinical trials.

Publication types

  • Meta-Analysis

MeSH terms

  • Clinical Trials, Phase II as Topic
  • Clinical Trials, Phase III as Topic
  • Docetaxel
  • Dose-Response Relationship, Drug
  • Ethnicity / genetics
  • Humans
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Neoplasms / epidemiology*
  • Neutropenia / chemically induced
  • Neutropenia / epidemiology
  • Neutropenia / pathology*
  • Taxoids / administration & dosage
  • Taxoids / adverse effects*
  • Taxoids / pharmacokinetics

Substances

  • Taxoids
  • Docetaxel