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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
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Related Experiment Video

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An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
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Refining sorafenib therapy: lessons from clinical practice.

Luigi Bolondi1, Antonio Craxi, Franco Trevisani

  • 1Division of Internal Medicine, Department of Medical & Surgical Sciences, University of Bologna, S Orsola-Malpighi Hospital, Bologna, Italy.

Future Oncology (London, England)
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Summary
This summary is machine-generated.

Maximizing sorafenib benefit in liver cancer involves careful dose adjustments for adverse events and considering symptomatic progression alongside radiologic response. Continue sorafenib beyond progression if other options are limited.

Keywords:
Child–Pugh Badverse event managementdose modificationelderlyhepatocellular carcinomamRECISTpostprogression treatmentreal-world dataresponse assessmentsorafenib

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Area of Science:

  • Hepatobiliary cancers
  • Medical oncology
  • Pharmacological management

Background:

  • Sorafenib is a key treatment for advanced hepatocellular carcinoma.
  • Optimizing its use is crucial for patient outcomes.
  • Managing side effects and response assessment are critical.

Purpose of the Study:

  • To provide evidence-based recommendations for maximizing sorafenib's clinical benefit in hepatocellular carcinoma.
  • To guide clinicians on dose modification, adverse event management, and response evaluation.
  • To support treatment continuation strategies.

Main Methods:

  • Review of Phase III and noninterventional study data.
  • Incorporation of extensive clinical experience.
  • Discussion of dose adjustments, interruption strategies, and response assessment criteria.

Main Results:

  • Sorafenib should start at 400 mg twice daily, with dose modifications for adverse events.
  • Considering symptomatic progression alongside radiologic response is vital for treatment decisions.
  • Continuing sorafenib beyond radiologic progression may benefit patients when alternatives are unavailable.

Conclusions:

  • Strategic dose modification and comprehensive response assessment can enhance sorafenib's efficacy.
  • Prolonging treatment duration, even beyond radiologic progression, can improve clinical benefit.
  • These recommendations aim to maximize treatment duration and patient outcomes in hepatocellular carcinoma.