Docetaxel secretion in tears: Association with lacrimal drainage obstruction

Objective: To test the hypothesis that docetaxel may be secreted in tears after intravenous infusion. Design: Prospective pilot trial. Patients and Methods: Tear fluid was collected from 4 patients receiving docetaxel weekly and 2 patients receiving docetaxel every 3 weeks as a single agent for the treatment of metastatic breast cancer. Tear samples were collected once prior to and again within 30 minutes following the end of the 1-hour docetaxel infusion. A blood sample was also obtained after infusion. The tear and plasma samples were analyzed for drug content using high-performance liquid chromatography and tandem mass spectrometry. Results: Docetaxel was found in the tear samples collected from all 6 patients. Conclusion: The secretion of docetaxel in tears may be a mechanism for canalicular inflammation and tear drainage obstruction, which are known to occur as an adverse effect of the drug.