Sorafenib

Grey

Brand Name(s):Nexavar

Indication:All licensed indications

Rationale:1

Considered:Mar-07

Review Date:Jul-20

Comments:
1.1 Sorafenib is not recommended for the treatment of advanced hepatocellular carcinoma in patients for whom surgical or locoregional therapies have failed or are not suitable.

1.2 People currently receiving sorafenib for the treatment of advanced hepatocellular carcinoma should have the option to continue treatment until they and their clinician consider it appropriate to stop.

NICE TA 189
Sorafenib for the treatment of advanced hepatocellular carcinoma May 2010

Bevacizumab, sorafenib and temsirolimus are not recommended as first-line treatment options for people with advanced and/or metastatic renal cell carcinoma.

Sorafenib and sunitinib are not recommended as second-line treatment options for people with advanced and/or metastatic renal cell carcinoma.

People who are currently being treated with bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for advanced and/or metastatic renal cell carcinoma should have the option to continue their therapy until they and their clinicians consider it appropriate to stop.

NICE TA 178
Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma August 2009

Doctors, nurses, pharmacists and their staff must be made aware that the prescribing, dispensing and administering of oral
anti-cancer medicines should be carried out and monitored to the same standard as injected therapy. This requires that:
* Healthcare organisations should prepare local policies and procedures that describe the safe use of these oral
medicines.
* Treatment should be initiated by a cancer specialist.
* All oral anti-cancer medicines should be prescribed only in the context of a written protocol and treatment plan.
* Non-specialists who prescribe or administer on-going oral anti-cancer medication should have ready access to
appropriate written protocols and treatment plans including guidance on monitoring and treatment of toxicity.
* Staff dispensing oral anti-cancer medicines should be able to confirm that the prescribed dose is appropriate for the
patient, and that the patient is aware of the required monitoring arrangements, by having access to information in the
written protocol and treatment plan from the hospital where treatment is initiated and advice from a pharmacist with
experience in cancer treatment in that hospital.
* Patients should be fully informed and receive verbal and up-to-date written information about their oral anticancer
therapy from the initiating hospital. This information should include contact details for specialist advice, which can be
shared with non-specialist practitioners. Written information, including details of the intended oral anti-cancer regimen,
treatment plan and arrangements for monitoring, taken from the original protocol should be given to the patient. When
shared with pharmacists and dispensing staff, this would enable the above dispensing requirements to be satisfied.
* Full use should also be made of NHS cancer centre web sites to provide information for healthcare staff, patients and carers to ensure the safe use of oral anti-cancer medicines.

Risks of incorrect dosing of oral anti-cancer medicines – NPSA January 2008