The Food and Drug Administration has approved sorafenib (Nexavar) for treating inoperable hepatocellular carcinoma. In a randomized clinical trial of 602 patients, the drug lengthened patients’ lives by almost 3 months. In fact, researchers stopped the trial at its midpoint, when interim analysis showed that patients who received sorafenib lived 10.7 months compared to 7.9 months for those who received a placebo.
   A kinase inhibitor already approved for treating advanced renal cell carcinoma, sorafenib interferes with communication between cancer cells, disrupting formation of blood vessels to the tumor. The most common adverse reactions include fatigue, weight loss, rash and other skin reactions, hair loss, diarrhea, anorexia, nausea, and abdominal pain. Other adverse effects include an increased risk of hypertension and myocardial infarction.
   Sorafenib comes as 200-mg tablets, and the usual dosage is 400 mg twice a day on an empty stomach.
   Hepatocellular carcinoma makes up the great majority of liver cancers and can be difficult to remove fully during surgery. If all the cancer can’t be removed, the patient typically dies within 3 to 6 months. Nearly 20,000 people are diagnosed with this form of liver cancer each year.

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