Real-world data of docetaxel-induced liver injury among hospitalized patients in Wuhan, China: A retrospective analysis

This study aims to analyze the risk factors of docetaxel-induced liver injury to provide evidence for the clinical prevention and treatment of docetaxel-induced liver injury. A retrospective analysis of patients who received docetaxel chemotherapy regimen from January 2017 to April 2018 in Renmin Hospital of Wuhan University was conducted. Univariate analysis and multivariate logistic regression analysis with the forward stepwise method were used to assess the risk factors associated with liver injury induced by docetaxel. Receiver-operator characteristic curve analysis was performed to calculate the area under the receiver-operator characteristic curve (AUC). In the study, 223 (7.88%) patients were diagnosed as docetaxel-induced liver injury, among which the patients with ovarian cancer had the highest incidence rate (8.33%). By logistic regression analysis, hepatitis B virus carrier, diabetes, docetaxel plus nedaplatin, docetaxel plus capecitabine, docetaxel plus epirubicin, and docetaxel plus cyclophosphamide chemotherapy regimens, were independently associated with drug-induced liver injury during receiving chemotherapy, respectively. Among them, diabetes and docetaxel plus cyclophosphamide were protective factors, but the others were risk factors. Further analysis by the risk score and AUC showed that those factors contributed to an AUC of 0.693 (95% confidence interval = 0.660-0.727), with a predictive sensitivity of 70.9% and specificity of 61.6%. Docetaxel-induced liver injury with a relatively higher incidence should be addressed among ovary cancer patients. The predominant risk factors of docetaxel-induced liver injury included hepatitis B virus carrier and docetaxel combination regimens, and the protective factor was diabetic patients. Among these therapeutic combination regimens, docetaxel plus epirubicin, docetaxel plus nedaplatin, and docetaxel plus capecitabine could significantly increase the occurrence of docetaxel-induced liver injury during hospitalization respectively, while docetaxel plus cyclophosphamide regime might be safer. Therefore, for patients with these risk factors, it might be advisable to actively consider optimum management to reduce the occurrence of docetaxel-induced liver injury during hospitalization, particularly hepatic function test.