Sorafenib
The first drug ever to extend life in advanced liver cancer (2007), now mostly a comparator arm that newer combinations are measured against.
Overview
SHARP: OS 10.7 vs 7.9 months versus placebo (HR 0.69). Standard first-line therapy for a decade until REFLECT (lenvatinib non-inferior) and IMbrave150 (atezolizumab-bevacizumab superior). Also approved in RCC and radioiodine-refractory thyroid cancer. Hand-foot skin reaction and diarrhoea dominate toxicity.
1.Enters tumour and endothelial cells
- Route
- Oral
- Schedule
- 400 mg twice daily continuously
- Dose modifications
- Dose reduction to 400 mg daily for grade 2-3 hand-foot skin reaction
- Monitoring
- Blood pressure, skin, liver function
- Medicare
- Part D (self-administered)
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Generic sorafenib is available.
- Commercial insurance
- covered on label
Multi-source generic on low-cost tiers; usually no prior authorisation. Cash prices without insurance are modest. Plans require the generic.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
- Appraised for
- Advanced HCC (Child-Pugh A)
- Notes
- Originally rejected (TA189, 2010) and funded via the old CDF; recommended after a price cut. Also differentiated thyroid cancer (TA535, 2018).
- NHS England
- Routinely funded for the appraised indication (or via managed access)
Sources: NICE TA474 · SMC advice: sorafenib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
- 16 Nov 2007ApprovalUS
Unresectable HCC on SHARP
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2005 | Advanced RCC |
| US | 2007 | Unresectable HCC |
| US | 2013 | Radioiodine-refractory differentiated thyroid cancer |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Diarrhoea | 39% | 8% |
| Hand-foot skin reaction | 21% | 8% |
| Fatigue | 22% | 4% |
SHARP. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Trials
topTrials recruiting now
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Latest papers
topQuery for this drug: (TITLE:"Sorafenib" OR ABSTRACT:"Sorafenib" OR TITLE:"Nexavar" OR ABSTRACT:"Nexavar") AND (radiopharmaceutical OR radioligand OR radionuclide OR theranostic OR "nuclear medicine" OR "molecular imaging" OR radiotracer OR scintigraphy OR cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Sorafenib, not a curated reading list.
Similar pages
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