Sorafenib in Hepatocellular Carcinoma: Hype or Hope?

Abstract

Hepatocellular carcinoma (HCC) is the fifth most commonly prevalent tumor worldwide and continues to have a dismal prognosis with an expected survival of 4-6 months. Effective systemic treatment options for advanced HCC are limited and its management is still a challenge to the physicians since these patients are not the potential candidates for surgical or ablative therapy. Sorafenib, an oral multikinase inhibitor, previously tested and found effective against other solid tumors, has been proven to be the first targeted therapeutic option to demonstrate a survival benefit for the treatment of advanced HCC via favorable effects on both proliferation and angiogenesis. However, additional controlled studies are awaited on the role of this agent in patients with advanced liver disease and as an adjunctive therapy in combination with other modalities, targeted at the multiple carcinogenic pathways involved. This contribution provides a comprehensive review of sorafenib, as a valuable option to significantly extend survival for patients with advanced HCC, with the results obtained from large-scale, randomized trials as its vivid backdrop.