Sorafenib (rINN), marketed as Nexavar by Bayer, is a drug approved for the treatment of advanced renal cell carcinoma (primary kidney cancer). It has also received "Fast Track" designation by the FDA for the treatment of advanced hepatocellular carcinoma (primary liver cancer), and has since performed well in Phase III trials.
Sorafenib is a small molecular inhibitor of Raf kinase, PDGF (platelet-derived growth factor), VEGF receptor 2 & 3 kinases and c Kit the receptor for Stem cell factor. A growing number of drugs target most of these pathways. The originality of Sorafenib lays in its simultaneous targeting of the Raf/Mek/Erk pathway.
Sorafenib is indicated for the treatment of unresectable hepatocellular carcinoma and advanced renal cell carcinoma.
No large changes in QTc interval were observed. After one 28-day treatment cycle, the largest mean QTc interval change of 8.5 ms (upper bound of two-sided 90% confidence interval, 13.3 ms) was observed at 6 hours post-dose on day 1 of cycle 2.
Mechanism of action
Sorafenib interacts with multiple intracellular (CRAF, BRAF and mutant BRAF) and cell surface kinases (KIT, FLT-3, VEGFR-2, VEGFR-3, and PDGFR-ß). Several of these kinases are thought to be involved in angiogenesis, thus sorafenib reduces blood flow to the tumor. Sorafenib is unique in targeting the Raf/Mek/Erk pathway. By inhibiting these kinases, genetic transcription involving cell proliferation and angiogenesis is inhibited.
Route of administration
Antineoplastic and Immunomodulating Agents
Chemical Actions and Uses
Combined Inhibitors of CYP3A4 and P-glycoprotein
Cytochrome P-450 CYP1A2 Inhibitors
Cytochrome P-450 CYP2B6 Inhibitors
Cytochrome P-450 CYP2B6 Inhibitors (moderate)
Cytochrome P-450 CYP2B6 Substrates
Cytochrome P-450 CYP2C19 Inhibitors
Cytochrome P-450 CYP2C8 Inhibitors
Cytochrome P-450 CYP2C8 Substrates
Cytochrome P-450 CYP2C9 Inhibitors
Cytochrome P-450 CYP2C9 Inhibitors (moderate)
Cytochrome P-450 CYP2D6 Inhibitors
Cytochrome P-450 CYP3A Inhibitors
Cytochrome P-450 CYP3A4 Substrates
Heterocyclic Compounds, 1-Ring
Molecular Mechanisms of Pharmacological Action
Protein Kinase Inhibitors
QTc-Prolonging Agents (Indeterminate Risk and Risk Modifying)
Drug Info/Drug Targets: DrugBank 3.0: a comprehensive resource for 'omics' research on drugs. Knox C, Law V, Jewison
T, Liu P, Ly S, Frolkis A, Pon A, Banco K, Mak C, Neveu V, Djoumbou Y, Eisner R, Guo AC, Wishart DS.
Nucleic Acids Res. 2011 Jan; 39 (Database issue):D1035-41. | PMID:21059682