Sorafenib in the Treatment of Advanced Hepatocellular Carcinoma

All about Sorafenib’s use in Advanced Hepatocellular Carcinoma

Background

Sorafenib is an oral kinase inhibitor that has been approved by the FDA. It is a prescription medicine that is used to treat a variety of cancer-related illnesses. The following are some of its most relevant indications:

• Advanced Hepatocellular Carcinoma
• Advanced Renal Cell Carcinoma
• Metastatic, Differentiated Thyroid Carcinoma

Hepatocellular Carcinoma

Hepatocellular Carcinoma is a type of primary liver cancer that occurs most often in patients with severe liver disease like Hepatitis B or C. It is the third most common type of cancer, one of the leading causes of mortality concerning cancer.

Sorafenib is the standard treatment option that is currently available for patients diagnosed with Advanced Hepatocellular Carcinoma. More significantly, it is the first-line treatment method for those patients of HCC that are not eligible for resection therapy.

Dose

Sorafina Sorafenib for Hepatocellular Carcinoma Tablet should be taken twice a day at a dose of 400 mg (2 × 200 mg tablets). The dose should be administered without food for better efficacy (provided: at least 1 hour before or 2 hours after food). Therapy with this medicine should be undertaken till the patient no longer benefits from it or when there is clear evidence of intolerable toxicity.

Role and Mechanism

Sorafenib, being a kinase inhibitor, interacts with certain types of kinases including intracellular and cell surface kinases. These include CRAF, KIT, FLT-3, VEGFR-2, BRAF, VEGFR-3, mutant BRAF, and PDGFR-ß. By such inhibitions, cell proliferation also gets inhibited.

Efficacy

The efficacy of Sorafenib (SORAFINA) can be described on the basis of hematological factors like hemoglobin, platelets, white blood cell levels, plus liver function factors like serum bilirubin, aspartate transaminase (AST), serum albumin levels, alkaline phosphatase (ALP), and alanine transaminase (ALT). Based on such factors, the results of certain trials demonstrated better outcomes in patients. This showed that Sorafenib can act as a promising clinical solution for Advanced Hepatocellular Carcinoma.

Limitations

Patients with Advanced Hepatocellular Carcinoma who are administering Sorafenib should be monitored for the following adverse reactions. The below-mentioned points are some of the common side effects, along with the actions to be taken by the physician to manage them.

• Grade 2 or above Cardiac ischemia: Discontinue the use of Sorafenib tablets permanently in such a case. Do not resume.
• Congestive Heart Failure: In the case of Grade 3 congestive heart failure, interrupt the therapy until the disease reaches below Grade 1. Once reached, administer a one-level decreased dose. Whereas in the case of Grade 4 congestive heart failure, discontinue permanently and do not resume.
• Hemorrhage requiring medical intervention: In the case of Grade 2 Hemorrhage, discontinue the treatment permanently and do not resume. Whereas in the case of Grade 2 asymptomatic, treat using anti-hypertensive therapy. Continue the use of Sorafenib as per the schedule and closely monitor the patient’s blood pressure.
• Hypertension: In the case of Grade 2 (symptomatic/persistent), interrupt the treatment until the symptoms resolve.
• Gastrointestinal Perforation: Any Grade Gastrointestinal Perforation requires permanent discontinuation of this medication.