Sorafenib for Metastatic Thyroid Cancer
All about Sorafenib’s use in Differentiated Thyroid Carcinoma
Abstract
Sorafenib is an approved drug belonging to the class of kinase inhibitors. It is a prescription medication that is used in the treatment of several conditions associated with cancer. Its major indications include the following:
Treatment of patients diagnosed with Unresectable Hepatocellular Carcinoma (HCC) i.e. those patients of HCC that are not eligible for resection therapy.
Treatment of patients diagnosed with Advanced Renal Cell Carcinoma.
Treatment of patients diagnosed with locally recurrent or metastatic, progressive, Differentiated Thyroid Carcinoma (DTC), provided: refractory to radioactive iodine treatment.
Sorafenib for Differentiated Thyroid Carcinoma is a major boon to the patients. The drug significantly improves progression-free survival when used in subjects with Metastatic Thyroid Cancer. It may also benefit patients who are no longer responding to therapy with radioactive iodine.
Role and Mechanism
Metastatic Thyroid Cancer is one of the most researched diseases in the field of Oncology. However, the use of Sorafenib in patients suffering from such a condition is no less a positive sign. Being a multikinase inhibitor, Sorafenib (SORAFINA) interacts with and inhibits certain intracellular and cell surface kinases namely CRAF, BRAF, mutant BRAF, KIT, FLT-3, VEGFR-2, VEGFR-3, and PDGFR-ß. Since most of these kinases play a vital role in the process of angiogenesis, such inhibitions reduce blood flow to the tumor. Due to this, the genetic transcription that involves tumor angiogenesis and cell proliferation are also inhibited. Thus, cell death occurs.
Dose
The recommended dose of Sorafenib is 400 mg (2 x 200 mg tablets) administered twice daily. The dose should be ideally taken without food (at least 1 hour before or 2 hours after having a meal). Treatment with this drug should continue until the patient is no longer getting the benefits from therapy or until evidence of unacceptable toxicity is observed.
Efficacy
More than seven trials were conducted involving patients with Differentiated Thyroid Carcinoma (papillary, follicular, and poorly differentiated). The results comprising analysis of the response, disease progression, toxicities, and intolerance demonstrated a promising role of Sorafenib in patients with DTC. However, careful management of adverse reactions is also needed.
Limitations
Temporary interruptions of Sorafenib are prescribed in patients with Thyroid Cancer that undergo major surgical operations or experience adverse reactions during the treatment period.
Although Sorafenib improves the overall survival of patients, it is important to look out for the right patients (as per the eligibility) and precise management of possible side effects. Plus, the trials depict that the survival of patients is dependent on liver function. Therefore, this should be made clear to the patients prior to the therapy.
