Can Sorafenib Be Taken For Advanced Liver Cancer?

Posted on Sat, 9 Jan 2016

Question: My dad is diagnosed with liver cancer advanced stage and getting chemotheraphy from last 1.3 yrs.

For every 3 months we are having regular check up of Whole abdomen scan, LFT, CBP.

Medicines we are using from starting are: Soranib tab 1 per day and other supporting vitamin tabs. Now I want to check is is this a standard treatment or do I have any other best option.

Answered by Dr. Indranil Ghosh (15 hours later)

Brief Answer:
sorafenib is standard for advanced liver cancer

Detailed Answer:
Hi
Thanks for your query.

As you have mentioned that your dad is suffering from advanced liver cancer, sorafenib is a standard treatment. But the dose is 4 tab per day and if a patient can't tolerate that, then reduce to 2-3 tab per day. So one tab per day seems low, unless this is the maximum he can tolerate.

There are other options like transarterial chemoembolisation and radioembolisation. You can discuss these with his treating physician. If you can upload the CT scan reports then I can also give some suggestions.

Hope this helps. I will be available for follow up.
Regards

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Indranil Ghosh (2 hours later)

Dosage of sorafenib is 200mg bottle of 30 tablets. 1 tablet per day. So do you think still its low dosage.

I am asking this because recently in our regular check up we see the size of tumour is increasing but still doctor did not suggested dosage increase. Will share reports in a day.

My dad also has other health problems like BP, sugar, Asthma, Heart enlarged for which he is taking medication every day.

Answered by Dr. Indranil Ghosh (7 hours later)

Brief Answer:
yes it is low dose

Detailed Answer:
It comes in 30 and 120 tab packs. Dose is 4 tab per day. If your dad could not tolerate 4 or even 2 tab per day, then it is fine. Otherwise it is low dose. If the tumor has increased more than 20% from the start then there is no point of continuing the current dose.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Indranil Ghosh (57 minutes later)

Ok. I have attached all reports from starting. Please let me know your valuable suggestions.

Answered by Dr. Indranil Ghosh (2 hours later)

Brief Answer:
maybe suitable for tace

Detailed Answer:
I think you should get interventional radiology opinion for considering transarterial chemoembolisation or tace.

Sorafenib dose increased if tolerated.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (5 minutes later)

What I understood is dosage can be increased if tolerated.

what is tace? I have no idea on it

Answered by Dr. Indranil Ghosh (1 minute later)

Brief Answer:
it is transarterial chemoembolisation

Detailed Answer:
Here the blood supply to the tumor is blocked by pushing chemo plus other substances in the liver artery. Works good for controlling the tumor.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (2 minutes later)

Ok will discuss with doctor next time we visit. Currently we are going for every 3 months is it ok?

After seeing reports what do you feel what stage it is?

Answered by Dr. Indranil Ghosh (8 hours later)

Brief Answer:
yes 3 monthly scan is ok

Detailed Answer:
Unfortunately stage is advanced. It is at least C in the bclc staging system which has 4 stages A to D.

But can be controlled with tace and sorafenib.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (13 minutes later)

Thanks for your guidance. Will talk to my doctor regarding increasing the dosage and TACE method.

Last thing is TACE new technology?

Answered by Dr. Indranil Ghosh (48 minutes later)

Brief Answer:
not so new

Detailed Answer:
Tace is there for long time. Radioembolisation has come up in last 5 years

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (1 hour later)

Thanks for your suggestions.

Answered by Dr. Indranil Ghosh (10 hours later)

Brief Answer:
you are welcome

Detailed Answer:
My best wishes for him

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar