Indications

• Hepatocellular Carcinoma (see Hepatocellular Carcinoma)
  • SHARP Trial
• Renal Cell Carcinoma (see Renal Cancer)
• Thyroid Cancer (see Thyroid Cancer): radioactive iodine-resistant cases

---

Pharmacology

• Tyrosine Kinase Inhibitor (see Tyrosine Kinase Inhibitors)
  • PDGF Receptor (PDGFR)
  • VEGF Receptor (VEGFR)
• Raf Kinase Inhibitor
  • B-Raf
  • C-Raf
• Effects
  • Induces Autophagy: which may suppress tumor growth (and may also result in drug resistance)

Metabolism

• xxx

---

Administration

• PO

Dose Adjustment

• Hepatic
• Renal

---

Adverse Effects

Cardiovascular Adverse Effects

• Congestive Heart Failure (CHF) (see Congestive Heart Failure)
  • Epidemiology: common (occurs in 1-10% of cases)
• Myocardial Ischemia/Infarction (see Coronary Artery Disease)
  • Epidemiology: common (occurs in 1-10% of cases)
• QT Prolongation without Definite Association with Torsade (see Torsade)
  • Epidemiology: rare (occurs in 0.01-0.1% of cases)

Dermatologic Adverse Effects

• Alopecia (see Alopecia): very common (>10% of cases)
• Angioedema (see Angioedema): rare (0.01-0.1% of cases)
• Chemotherapy-Induced Acral Erythema (Hand-Foot Syndrome, Palmar-Plantar Erythrodysesthesia) (see Chemotherapy-Induced Acral Erythema): very common (>10% of cases)
• Erythema Multiforme (see Erythema Multiforme): uncommon (0.1-1% of cases)
• Erythroderma (see Erythroderma): very common (>10% of cases)
• Exfoliative Dermatitis/Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (see Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis)
• Pruritus (see Pruritus): very common (>10% of cases)
• Rash: very common (>10% of cases)

Gastrointestinal Adverse Effects

• Diarrhea (see Diarrhea): very common (>10% of cases)
• Gastrointestinal Perforation (see Intestinal Perforation): uncommon (0.1-1% of cases)
• Nausea/Vomiting (see Nausea and Vomiting): very common (>10% of cases)
• Pancreatitis (see Acute Pancreatitis): uncommon (0.1-1% of cases)
  • Elevated Amylase/Elevated Lipase: very common (>10% of cases)

Hematologic Adverse Effects

• Pancytopenia (see Pancytopenia): common (1-10% of cases)
• Anemia (see Anemia)
• Leukopenia/Neutropenia (see Leukopenia and Neutropenia)
• Thrombocytopenia (see Thrombocytopenia)

Neurologic Adverse Effects

• Posterior Reversible Encephalopathy Syndrome (PRES) (see Posterior Reversible Encephalopathy Syndrome)

Pulmonary Adverse Effects

• Interstitial Lung Disease (ILD) (see Interstitial Lung Disease): uncommon (0.1-1% of cases)

Renal Adverse Effects

• Acute Kidney Injury (AKI) (see Acute Kidney Injury): common (1-10% of cases)
• Hypertension(see Hypertension): very common (>10% of cases)
• Hypocalcemia (see Hypocalcemia): common (1-10% of cases)
• Hypokalemia (see Hypokalemia): common (1-10% of cases)
• Hypophosphatemia (see Hypophosphatemia): very common (>10% of cases)
• Rhabdomyolysis (see Rhabdomyolysis): rare (0.01-0.1% of cases)

Other Adverse Effects

• Anaphylaxis (see Anaphylaxis): rare (0.01-0.1% of cases)
• Fever (see Fever): common (1-10% of cases)
• Hemorrhage: very common (>10% of cases)
• Infection: uncommon (0.1-1% of cases)
• Pain: very common (>10% of cases)

---

References

• Perforating folliculitis, angioedema, hand-foot syndrome–multiple cutaneous side effects in a patient treated with sorafenib. J Dtsch Dermatol Ges. 2009 May;7(5):449-52 [MEDLINE]