Sorafenib
Indication
Hepatic cell carcinoma, Advanced renal cell carcinoma, Differentiated thyroid carcinoma.
Off label indication
Angiosarcoma (recurrent or metastatic), Gastrointestinal stromal tumor (resistant or refractory).
Mechanism of action
Sorafenib is a multikinase inhibitor that inhibits tumor growth and angiogenesis by inhibiting intracellular Raf kinases (CRAF, BRAF, and mutant BRAF), and cell surface kinase receptors (VEGFR-1,2,3, PDGFR-beta, cKIT, FLT-3, RET, and RET/PTC).
Dosage and administration
Oral-400mg twice daily (available dosage form-200mg tablet).
Administer without food (at least 1 hour before or 2 hours after meal).
Contraindications
Known severe hypersensitivity to sorafenib, use in combination with carboplatin and paclitaxel in patients with squamous cell lung cancer.
Drug-Interactions
Strong CYP3A Inducers – Avoid concomitant use of strong CYP3A4 inducers (such as, carbamazepine, dexamethasone, phenobarbital, phenytoin, rifampin, rifabutin), when possible, because these drugs can decrease the systemic exposure to sorafenib.
Adverse Effects
| Common Adverse Effects | Serious Adverse Effects |
|---|---|
| Nausea, vomiting, diarrhoea, alopecia, weight loss, loss of appetite, skin rashes, fatigue, abdominal pain. | Cardiovascular events (cardiac ischemia or infarction, heart failure), Haemorrhage, Hypertension, Dermatological toxicity (especially Hand-Foot syndrome, SJS), Gastrointestinal Perforation, QT Prolongation, Drug-Induced Liver Injury, Embryo-Fetal Toxicity, Impaired wound healing, Impairment of TSH Suppression in DTC. |
