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Cerebrovascular accidents associated with sorafenib in hepatocellular carcinoma

Muhammad W Saif1, Iris Isufi, Jennifer Peccerillo

  • 1Division of Hematology, Oncology, Department of Medicine, Columbia University, NY 10027, USA.

Gastroenterology Research and Practice
|June 21, 2011
PubMed

Insights

Sorafenib, an angiogenetic multikinase inhibitor, rarely causes cerebrovascular accidents. Two hepatocellular carcinoma patients developed strokes on sorafenib, prompting discontinuation and physician monitoring for neurologic symptoms.

Area of Science:

  • Oncology
  • Neurology
  • Pharmacology

Background:

  • Sorafenib is an oral multikinase inhibitor used for renal and hepatocellular carcinoma.
  • Angiogenetic agents like sorafenib are associated with bleeding and thrombotic events.
  • Cerebrovascular accidents are rare but potential adverse events associated with these agents.

Observation:

  • Two hepatocellular carcinoma patients on sorafenib developed cerebrovascular accidents.
  • Patients lacked typical risk factors for cerebrovascular events.
  • Standard diagnostic workups, including head CT, carotid ultrasound, and echocardiogram, were non-contributory.

Findings:

  • Cerebrovascular accidents occurred in patients treated with sorafenib.
  • No alternative causes for the cerebrovascular events were identified.
  • Discontinuation of sorafenib was implemented in both cases.

Implications:

  • Physicians should be vigilant for neurologic symptoms in patients receiving sorafenib.
  • Consider sorafenib discontinuation if cerebrovascular accidents occur without other identifiable causes.
  • This highlights a rare but serious adverse event associated with sorafenib therapy.

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