Oral Docetaxel in Patients With Normal or Impaired Liver Function

This is an interventional treatment trial for Solid Tumor, Adult Read More

Inclusion Criteria:

1. Histological or cytological proof of cancer
2. Patients who might benefit from a weekly (oral) docetaxel regime

3. One of the following options regarding liver impairment:

   • Normal liver function: Child-Pugh A classification and normal (<ULN) values of total bilirubin and ASAT/ALAT)

   • Presence of liver impairment according to the following characteristics:

     • Child-Pugh A and elevated (>ULN) values of total bilirubin and/or ASAT/ALAT (as described in table 3 or Appendix VI)
     • Child-Pugh B
4. Age ≥ 18 years;
5. Able and willing to give written informed consent;
6. WHO performance status of 0, 1 or 2;
7. Able and willing to undergo blood sampling for PK analysis;
8. Life expectancy > 3 months;

9. Minimal acceptable laboratory values defined as:

   1. Hb ≥ 6.0 mmol/L
   2. ANC of ≥ 1.5 x 109 /L
   3. Platelet count of ≥ 100 x 109 /L
   4. Renal function as defined by serum creatinine ≤ 1.5 x ULN or creatinine clearance ≥ 50 mL/min (by Cockcroft-Gault formula);
10. Negative pregnancy test (urine/serum) for female patients with childbearing potential;
11. Able and willing to swallow oral medication

Exclusion Criteria:

1. Severe liver impairment classified as Child-Pugh C
2. Concomitant use of anticoagulant drugs that can or do alter the PT-INR
3. Other causes of elevated bilirubin than intrinsic liver impairment (as described in appendix VII)
4. Concomitant use of MDR and CYP3A modulating drugs such as Ca+-entry blockers (verapamil, dihydropyridines), cyclosporine, quinidine, quinine, tamoxifen, megestrol and grapefruit juice, concomitant use of HIV medications; other protease inhibitors, (non) nucleoside analoga, St. Johns wort or macrolide antibiotics.
5. Bowel obstructions or motility disorders or gastrectomy that may influence the absorption of drugs
6. Neurologic disease that may render a patient at increased risk for peripheral or central neurotoxicity
7. Patients with symptomatic brain metastases or with leptomeningeal metastases. Patients with brain metastases are allowed if they received adequate treatment, are asymptomatic in the absence of corticosteroid therapy and anticonvulsant therapy for at least 6 weeks. Radiotherapy for brain metastases must have been completed at least 4 weeks prior to start of study treatment. Brain metastases must be stable with verification by imaging (e.g. brain MRI or CT completed at screening).
8. Unresolved > grade 1 toxicities of previous systemic therapy, except for alopecia
9. Woman who are pregnant or breast feeding;
10. Unreliable contraceptive methods. Both men and women enrolled in this trial must agree to use a reliable contraceptive method throughout the study (adequate contraceptive methods are: condom, sterilization, other barrier contraceptive measures preferably in combination with condoms)
11. Radio- or chemotherapy or any treatment with investigational drugs within the last 4 weeks prior to receiving the first dose of investigational treatment (palliative limited radiation for pain reduction is allowed);
12. Uncontrolled infectious disease or known Human Immunodeficiency Virus HIV-1 or HIV-2 type patients;
13. Patients with known alcoholism, drug addiction and/or psychiatric of physiological condition which in the opinion of the investigator would impair study compliance;
14. Evidence of any other disease, neurological or metabolic dysfunction, physical examination finding or laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or puts the patient at high risk for treatment-related complications;
15. Legal incapacity