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Toxicity of sorafenib: clinical and molecular aspects
Benoit Blanchet1, Bertrand Billemont, Stéphane Barete
1Laboratoire de Pharmacologie-Toxicologie, Service de Pharmacie, GH Cochin-Saint Vincent-de-Paul, 75014 Paris, France. benoit.blanchet@cch.aphp.fr
Importance Of The Field:
Sorafenib is a novel oral bis-aryl urea compound originally developed as an inhibitor of RAF kinase for its anti-proliferative property. Sorafenib also inhibits receptor tyrosine kinases of multiple pro-angiogenic factors such as VEGFR-1/2/3, Flt-3 and PDGFR-beta. The combination of both its anti-proliferative and anti-angiogenic properties makes sorafenib an attractive agent in cancer treatment. Sorafenib has been approved for the treatment of metastatic renal cell carcinoma as well as hepatocellular cancer. Despite its inherent selectivity, sorafenib can cause unusual adverse events whose the management represents a challenge for oncologists.
Areas Covered In This Review:
Relevant literature was identified using a Pubmed search of articles published up to June 2009. Search terms included 'sorafenib' and 'toxicity'. Original articles were reviewed and relevant citations from these articles were also considered.
What The Reader Will Gain:
The clinical aspect of sorafenib-induced adverse events and the molecular basis behind this toxicity are discussed. Finally, recommendations for the management of these adverse events are proposed.
Take Home Message:
Although not life-threatening, toxicity of sorafenib can severely impact the physical, psychological and social well-being of patients. The management of this unusual toxicity highlights the particular need of new pluridisciplinarities linking oncologist, cardiologist and dermatologist.
Insights
Sorafenib, a cancer treatment, can cause unusual side effects impacting patient well-being. Managing sorafenib toxicity requires a multidisciplinary approach involving oncologists, cardiologists, and dermatologists.
Area of Science:
- Oncology
- Pharmacology
Background:
- Sorafenib is a RAF kinase inhibitor with anti-proliferative and anti-angiogenic properties.
- Approved for metastatic renal cell carcinoma and hepatocellular cancer.
- Sorafenib exhibits selectivity but can cause challenging adverse events.
Purpose of the Study:
- To discuss the clinical and molecular aspects of sorafenib-induced adverse events.
- To propose management strategies for sorafenib toxicity.
Main Methods:
- Literature search of PubMed up to June 2009 using terms 'sorafenib' and 'toxicity'.
- Review of original articles and relevant citations.
Main Results:
- Discussion of the clinical presentation of sorafenib adverse events.
- Exploration of the molecular mechanisms underlying sorafenib toxicity.
- Recommendations for managing sorafenib-induced adverse events.
Conclusions:
- Sorafenib toxicity, while not typically life-threatening, significantly affects patient quality of life.
- Effective management necessitates a multidisciplinary approach involving oncologists, cardiologists, and dermatologists.
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Toxic Reactions: Overview
Toxicity falls into two primary categories: local and systemic.
Local toxicity appears at the exposure site, such as protein denaturation caused by caustic substances.
In contrast, systemic toxicity requires the toxic agent's absorption and distribution,...
