Sorafenib can be used to treat a type of kidney cancer called renal cell carcinoma (RCC), Sorafenib can also be used to treat a kind of liver cancer called hepatocellular carcinoma (HCC). In addition, it can be used to treat other types of cancer as part of a research trial.

WHAT IS SORAFENIB?

Sorafenib is a type of treatment called a multikinase inhibitor. Kinases are important proteins for the body that regulate the way cells grow and divide.

HOW DOES SORAFENIB WORK?

Sorafenib acts by blocking signals within the cancer cells that make them grow and divide. Blocking the signals causes them to die.

Sorafenib can also halt the development of new blood vessels inside cancer cells. This reduces the supply of oxygen and nutrients, making the tumor shrink or stop growing. Drugs that interfere with the growth of blood vessels this way are called angiogenesis inhibitors or anti-angiogenics.

WHEN IS SORAFENIB USED?

Sorafenib is used to treat people with kidney cancer that has spread beyond the kidney (advanced or metastatic renal cell cancer) and who are no longer being helped by treatment with interferon alpha (IFN) or interleukin-2 (IL-2) or for whom these drugs are not suitable.

Sorafenib can also also be used to treat a kind of liver cancer called hepatocellular carcinoma (HCC). HCC is the most common primary liver cancer (cancer that starts in the liver). Sorafenib can be used to treat HCC that cannot be surgically removed.

Sorafenib is also being studied as a possible treatment for other types of cancer and for kidney cancer that can be removed surgically (early kidney cancer).

WHAT DOES SORAFENIB LOOK LIKE?

Sorafenib is a red, round tablet.

HOW IS SORAFENIB ADMINISTERED?

Sorafenib should be taken on an empty stomach with a glass of water at least one hour before a meal or two hours after. It is normally taken twice a day.

Usually, sorafenib is taken while the cancer is being kept under control or until the side effects become too bothersome.

POSSIBLE SIDE EFFECTS OF SORAFENIB

Each person reacts differently to cancer treatment. Some people have very few side effects, while others may develop more. The side effects described here will not affect everyone who is treated with the drug.

We outline the most commonly side effects, though we have left out the rarer ones. If you notice you develop any side effects that are not listed here, talk to your doctor or specialist nurse.

The side effects of sorafenib are normally minor. These may disappear during the treatment as your body adapts to the drug.

HAND/FOOT SKIN REACTION

This is common. You may notice reddening on the palms of your hands of the soles of your feet. At times, the hands and feet become painful and inflamed. You may also have changes in sensation, such as numbness or tingling. Tell your specialist if this happens.

Sometimes, if the pain does not go away or if blistering occurs, your doctors may need to lower the dose of sorafenib or interrupt the treatment. Rarely, people may need to discontinue the treatment.

Skin changes such as rashes, redness, dryness, or itchiness are very common. These side effects are normally minor. Tell your doctor or nurse if you have any of these symptoms. They can recommend creams or lotions you can use; also, they can prescribe drugs to relieve the itchiness.

TIREDNESS (FATIGUE)

Tiredness is a common side effect, especially toward the end of treatment and for a few weeks after the treatment has finished. It is important that you try to pace yourself and rest as much as you need to. Try to balance this with light exercise, such as taking short walks. If you feel drowsy, don't drive or operate heavy machinery.

DIARRHEA

You may experience more frequent or loose bowel movements. Normally, this can be easily controlled with drugs, so tell your doctor if your diarrhea is severe or ongoing. It's important to drink lots of fluids if you have diarrhea.

SORENESS OF THE MOUTH AND MOUTH ULCERS

Your mouth may become sore or dry or you may develop small ulcers during your treatment. Some find that sucking on ice can help. Drinking lots of fluids and regularly brushing your teeth gently using a soft-bristled toothbrush can help lower the risk of this happening. Tell your doctor or nurse if you have any of these problems, as they can prescribe a mouthwash and drugs to prevent infection in the mouth.

NAUSEA AND VOMITING

Your doctor can prescribe antiemetic drugs to prevent or greatly reduce your nausea or vomiting. If your nausea remains uncontrolled or continues, tell your doctor.

Some of these drugs can cause constipation. Tell your doctor or nurse if this is a problem.

CONSTIPATION

In general, it helps to drink lots of fluids, eat more fiber, and get some light exercise. You may need to take drugs (laxatives) to help.

HAIR THINNING

You may notice that your hair thins out. It is very unlikely that all your hair will fall out. Hair loss is temporary, and your hair will grow back once the treatment has concluded.

HOARSENESS

You may develop hoarseness in your voice.

JOINT PAIN (ARTHRALGIA)

Some people have pain in their muscles, joints, or bones while they are having the treatment. If this is your case, your doctor can prescribe painkillers to help.

BLEEDING PROBLEMS

Sorafenib can increase the risk of bleeding. This is a less common side effect and can affect people in different ways. For example, your gums may bleed, or you may bruise more easily or notice blood in your urine or stool. If you notice any unusual bleeding, get in touch with your doctor immediately.

HEART PROBLEMS

Sorafenib can sometimes cause problems with the supply of blood to the heart. If you have pain in your chest, difficulty breathing, or other symptoms, it may mean that your heart is affected, so get in touch with your doctor immediately.

SLOW WOUND HEALING

Wounds may take longer to heal while you are being treated with sorafenib. If you have any surgical procedures scheduled, you may have to stop taking sorafenib before the operation and not start taking it again for a few weeks afterward. Your doctor can give you further advice on this.

ADDITIONAL INFORMATION ON SORAFENIB

OTHER MEDICINES

Some drugs, including those bought over the counter in a store or pharmacy, may be harmful to you while you are taking sorafenib. Tell your doctor if you are taking any medicines, including over-the-counter medications, complementary therapies, and herbal medicines.

FERTILITY

This treatment may affect your ability to conceive. It is important that you talk to your doctor before beginning treatment.

CONTRACEPTION

Little is known about the effects of sorafenib on developing babies. Therefore, it is not recommendable to become pregnant while taking this drug.

It is unknown whether sorafenib is present in semen or vaginal fluid. In order to protect your partner, it is safest to avoid having sex or use a barrier contraceptive device for about 48 hours after the chemotherapy.

BREASTFEEDING

There is a potential risk that sorafenib may be present in breast milk, and therefore women are recommended not to breast feed during the treatment and for a few months afterward.

HOSPITAL ADMISSION

If you are admitted to the hospital for any reason not related to cancer, it is important that you tell your doctors and nurses caring for you that you are receiving treatment with sorafenib.

OTHER ISSUES TO KEEP IN MIND ABOUT SORAFENIB CAPSULES

It is important to take your capsules as your doctors said.

Keep them in a safe place out of the reach of children. Pregnant women should not handle the capsules.

If you forget to take a capsule, do not take a double dose. Tell your doctor and maintain your normal dose schedule.

Tell your doctor if you vomit right after taking the capsules. You may have to take another dose. Do not take any more until you talk to your doctor, nurse, or pharmacist.

If your doctor decides to halt your treatment, return the remaining capsules to the hospital. Do not flush them down the toilet or throw them away.