title: Safe use of sorafenib in a patient undergoing salvage liver transplantation for recurrent hepatocellular carcinoma after hepatic resection.
abstract: Sorafenib, a multikinase inhibitor targeting angiogenesis, cell survival, and proliferation in hepatocellular carcinoma (HCC) is a standard therapy for advanced stage disease. However, its utilization as neoadjuvant therapy is under investigation and remains an off label indication. The use of sorafenib in pre-liver transplant setting raises caveats associated with risk of bleeding, wound healing deficiencies, and hepatic decompensation. Herein, we report the case of a patient who after exhibiting HCC relapse post-hepatic resection underwent sorafenib therapy and subsequent transplantation. Sorafenib was well tolerated, and no adverse events were noticed. The use of sorafenib as neoadjuvant therapy in pre-transplant patients is feasible and deserves investigation in large clinical settings.
authors.affiliation: Taussig Cancer Center, Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Kim
authors.forename: Narayanan
authors.initials: N
authors.lastname: Menon
authors.forename: Federico
authors.initials: F
authors.lastname: Aucejo
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000627:therapeutic use*; D016879:Salvage Therapy / Q000379:methods*; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib