2598 Background: The transactivations of the metabolism enzymes (CYP3A4/5) and efflux transporters (ABCB1/ABCC2) involved in docetaxel disposition are regulated by the orphan nuclear receptors such as PXR, CAR, RXRα and HNF4α. This study aimed to explore the associations between the genetic variations present in the genes encoding the orphan nuclear receptors, RXRα and HNF4α, on docetaxel disposition. Methods: The DNAs from healthy Chinese, Malay and Indian subjects (n=56 each) were screened for RXRα and HNF4α SNPs in exons and intronic/exonic boundaries by direct sequencing. The high frequency SNPs (>1%) were profiled in a cohort of local nasopharyngeal cancer patients (n=54). Genotypic-phenotypic correlations were conducted using Mann-Whitney U-test and Kruskal-Wallis test. Results: Eighty-eight and sixty-nine SNPs were identified from the healthy screening of RXRα and HNF4α, respectively, across 3 populations. A total of 30 and 35 high frequency SNPs in RXRα and HNF4α, respectively, were profiled in the patients. Six RXRα SNPs [IVS2+33G>A (rs2234753), IVS7+70A>G (rs1536475),*846G>A (rs4240711), *+4458G>A (rs3132291), *+4768C>A (rs4842196) and *+4988A>G (rs4842198)] and 6 HNF4α SNPs [-728A>C (rs1800963), IVS2-278A>G (rs55934816), IVS6+141A>G (rs6103731), IVS7-88T>C (rs2273618), IVS9–145T>C (rs3746574) and IVS9-67C>G (rs3746575)] were significantly associated with higher clearance and lower AUC0-∞ and/or Cmax of docetaxel (P<0.05). Conversely, HNF4α SNP [IVS9+354G>T (rs3818247)] was associated with lower clearance and higher AUC0-∞ and Cmax of docetaxel (p<0.05). A high linkage pattern was observed among the abovementioned RXRα SNPs except for IVS2+33G>A (rs2234753) (D'≥0.74). Similarly, HNF4α SNPs were found to be highly linked, except for -728A>C (rs1800963) (D'≥0.62). Conclusions: The results highlight the contributions of RXRα and HNF4α pharmacogenetics in influencing the inter-individual variability in docetaxel disposition in Asian nasopharyngeal patients.