Clinical Management and Case Reports for the Treatment of Hepatocellular Carcinoma With SorafenibFrenette, Catherine T. MD*,†; Frederick, Richard Todd MD*,†; Gish, Robert G. MD*,†Journal of Clinical Gastroenterology: September 2011 - Volume 45 - Issue 8 - p 733–737 doi: 10.1097/MCG.0b013e3181f68e83 LIVER, PANCREAS AND BILIARY TRACT: Case Report Abstract Author Information Hepatocellular carcinoma (HCC) is one of the most common solid organ malignancies worldwide, and its incidence is rising in industrialized nations. Sorafenib, an oral multikinase inhibitor, is effective for the treatment of advanced HCC, and is the only systemic drug indicated for the treatment of unresectable HCC. Patients with HCC often have cirrhosis due to viral infection, chronic alcohol consumption, or other causes of liver damage, resulting in reduced liver function of variable severity. Because of the heterogeneity of HCC cases, physicians must consider the benefits and risks associated with sorafenib treatment on a patient-by-patient basis. California Pacific Medical Center (PMC) has established a clinical protocol, discussed here, for treatment of HCC with sorafenib, and for management of treatment-associated adverse effects. In addition, 3 case reports are presented as examples of the use of sorafenib in patient populations not represented in the phase 3 trials: as an adjuvant treatment after a surgical procedure and as effective treatment for stabilizing recurrent and metastatic HCC. Departments of *Medicine †Transplant, California Pacific Medical Center, San Francisco, CA Funding provided by Bayer HealthCare Pharmaceuticals and Onyx Pharmaceuticals, Inc. Reprints: Catherine T. Frenette, MD, Medical Director of Hepatocellular Carcinoma Program, California Pacific Medical Center (CPMC), GI/Hepatology Lawrence House/POB 232, 2340 Clay Street, 3rd Floor, San Francisco, CA (e-mail: firstname.lastname@example.org). © 2011 Lippincott Williams & Wilkins, Inc.