• Journal of Haehwa Medicine
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• v.28 no.2
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• pp.54-59
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• 2019

Objectives : The purpose of this case study is to report the effect of Korean medicine on hand-foot syndrome(HFS) casued by sorafenib(nexavar) in hepatocellular carcinoma. Methods : The patient, 77-year-old patient complaining with pain, swelling and erythema on both hands and feet which is characterized as HFS was treated with Jaungo. We evaluated the symptoms by Numeric Rating Scale and pictures. Results : The symptoms of HFS has been alleviated during the treatment. Conclusions : We suggest Jaungo as one of the alternative therapies for HFS due to sorafenib.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.155-158
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• 2016

Sorafenib (Nexavar) has been regarded as a treatment for unresectable hepatocellular carcinoma (HCC), with side effects that include hand-foot skin reaction, diarrhea, rash, fatigue, hypertension, nausea, anorexia, weight loss, and alopecia. Thyroid disorder, such as endocrine side effect, has also been reported. However no case involving adrenal insufficiency has been reported. Here, we report a case of adrenal insufficiency which occurred after taking sorafenib in a patient with HCC. A 56-year-old man visited our hospital due to right upper quadrant abdominal pain and he was diagnosed as multiple disseminated and unresectable HCCs with portal vein invasion; therefore transarterial chemoembolization was performed and sorafenib administration was started. Two months later, he was admitted to the hospital complaining of severe fatigue. The laboratory results showed cortisol of <$0.2{\mu}g/dL$ and adrenocorticotropic hormone of <1.00 pg/mL. The patient had no history of taking steroids or herbal medications. Secondary adrenal insufficiency was diagnosed and prednisolone 10 mg per day was started immediately; as a result, fatigue remarkably improved. This may be the first report indicating a possible association between sorafenib and adrenal insufficiency and it implies that the possibility of adrenal insufficiency should be considered in patients taking sorafenib who complain of severe fatigue.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.152-155
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• 2013

Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).

• Journal of Korean Traditional Oncology
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• v.21 no.2
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• pp.63-74
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• 2016

Objective : The purpose of this study is to report the effects of radio-frequency hyperthermia cancer treatment in conjunction with Sorafenib on hepatocellular carcinoma patient. Method : The patient was diagnosed with hepatocellular carcinoma at S6/7 and treated with right posterior sectionectomy. After 4 months, tumor recurrence was found at S4, 5 and 8. After transarterial chemoembolization, the patient was prescribed Sorafenib (proprietary name $Nexavar^{(R)}$ ) as well as proceeding with radio-frequency hyperthermia. The clinical outcomes were measured by computed tomography, laboratory findings including tumor markers (AFP, PIVKA-II), natural killer (NK) cell activity, and numeric rating scales (NRS). Results : After the treatment, tumor size was decreased accompanying by reducing the level of tumor markers (AFP, PIVKA-II). Major clinical symptoms were improved with increasing NK cell activity. There were no adverse events based on National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Conclusion : This case suggests that radio-frequency hyperthermia has synergistic effect for the treatment of hepatocellular carcinoma patient in conjunction with Sorafenib.

• Journal of Society of Preventive Korean Medicine
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• v.18 no.2
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• pp.89-100
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• 2014

Objective : The co-administration effects of Gongjindan (GJD) on the pharmacokinetics (PK) of sorafenib were observed as a process of the comprehensive and integrative medicine. Methods : After sorafenib treatment, GJD was administered within 5 min. The plasma were collected at 30min before administration, 30min, 1, 2, 3, 4, 6, 8 and 24hrs after end of GJD treatment, and plasma concentrations of sorafenib were analyzed using LC-MS/MS methods. PK parameters of sorafenib ($T_{max}$, $C_{max}$, AUC, $t_{1/2}$ and $MRT_{inf}$) were analysis as compared with sorafenib single administered rats. Results : The absorption of sorafenib were significantly increased at 30min, 1, 6 and 6hrs after co-administration with GJD as compared with sorafenib single treated rats. Accordingly, the $AUC_{0-t}$ (47.20%) of sorafenib was significantly increased but $t_{1/2}$ (-30.63%) and $MRT_{inf}$ (-34.11%) in co-administered rats were non-significantly decreased. These findings are considered as direct evidences that GJD increased the oral bioavailability of sorafenib through increase of the absorption, when they co-administered within 5min. Conclusion : Based on the results, co-administration of GJD increased the oral bioavailability of sorafenib through increase of the gastrointestinal absorption. It is considered that the more detail pharmacokinetic studies should be tested to conclude the effects of GJD on the pharmacokinetics of sorafenib, when they were co-administered, like the effects after co-administration with reasonable intervals considering the $T_{max}$ of sorafenib (about 3.5hr-intervals) and after repeated co-administrations.Hence, concomitant uses of GJD with sorafenib may require close monitoring for potential drug interactions.