title: Fatal case of sorafenib-associated idiosyncratic hepatotoxicity in the adjuvant treatment of a patient with renal cell carcinoma.
abstract: BACKGROUND
  Sorafenib is an orally available kinase inhibitor with activity at Raf, PDGFβ and VEGF receptors that is licensed for the treatment of advanced renal cell carcinoma (RCC) and hepatocellular carcinoma (HCC). Current evidence-based post-nephrectomy management of individuals with localized RCC consists of surveillance-based follow up. The SORCE trial is designed to investigate whether treatment with adjuvant sorafenib can reduce recurrence rates in this cohort.
  
  
  METHODS
  Here we report an idiosyncratic reaction to sorafenib resulting in fatal hepatotoxicity and associated renal failure in a 62 year-old man treated with sorafenib within the SORCE trial.
  
  
  CONCLUSIONS
  This is the first reported case of sorafenib exposure associated fatal toxicity in the adjuvant setting and highlights the unpredictable adverse effects of novel adjuvant therapies.
authors.affiliation: Department of Oncology, Cancer and Haematology Centre, Churchill Hospital, Oxford OX3 7LJ, UK.
authors.forename: B P
authors.initials: BP
authors.lastname: Fairfax
authors.forename: S
authors.initials: S
authors.lastname: Pratap
authors.forename: I S D
authors.initials: IS
authors.lastname: Roberts
authors.forename: J
authors.initials: J
authors.lastname: Collier
authors.forename: R
authors.initials: R
authors.lastname: Kaplan
authors.forename: A M
authors.initials: AM
authors.lastname: Meade
authors.forename: A W
authors.initials: AW
authors.lastname: Ritchie
authors.forename: T
authors.initials: T
authors.lastname: Eisen
authors.forename: V M
authors.initials: VM
authors.lastname: Macaulay
authors.forename: A
authors.initials: A
authors.lastname: Protheroe
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D017809:Fatal Outcome; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000009:adverse effects*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D009536:Niacinamide; D000077157:Sorafenib