title: Management of common adverse events in patients treated with sorafenib: nurse and pharmacist perspective.
abstract: Sorafenib, a tyrosine kinase inhibitor, is indicated for the treatment of patients with unresectable hepatocellular carcinoma (HCC) and advanced renal cell carcinoma (RCC). Sorafenib is currently being evaluated in phase II and III trials in various malignancies as a single agent (locally advanced/metastatic radioactive iodine-refractory differentiated thyroid cancer [DTC]), as part of multimodality care (HCC), and in combination with chemotherapies (metastatic breast cancer). Grade 1 and 2 adverse events (AEs) that commonly occur during treatment (ie, dermatologic manifestations, diarrhea, fatigue, and hypertension) should be proactively managed. The goal is to allow patients to remain on their full dose of sorafenib for as long as their treatment is indicated. A combination of early recognition of and intervention for AEs, patient education, and an open dialogue between patients and their multidisciplinary healthcare team, with timely reporting of AEs, will allow for effective management of AEs and minimize the need for sorafenib dose reduction or discontinuation.
authors.affiliation: Applied Clinical Scientist, Moffitt Cancer Center, Tampa, FL.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Walko
authors.affiliation: Nurse Practitioner, Hospital of the University of Pennsylvania, Department of Otorhinolaryngology, Philadelphia, PA. Electronic address: Carolyn.Grande@uphs.upenn.edu.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Grande
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy; D002292:Carcinoma, Renal Cell / Q000188:drug therapy; D019468:Disease Management; D005221:Fatigue / Q000139:chemically induced / Q000628:therapy; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000628:therapy; D060831:Hand-Foot Syndrome / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000628:therapy; D007680:Kidney Neoplasms / Q000188:drug therapy; D008113:Liver Neoplasms / Q000188:drug therapy; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009726:Nurses; D010353:Patient Education as Topic; D010595:Pharmacists; D010671:Phenylurea Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib