Dermatologic symptoms associated with the multikinase inhibitor sorafenib

J Am Acad Dermatol. 2009 Feb;60(2):299-305. doi: 10.1016/j.jaad.2008.06.034. Epub 2008 Nov 25.


Background: The multikinase inhibitor sorafenib (Nexavar) is associated with a relatively high incidence of dermatologic symptoms.

Objective: We sought to evaluate and provide guidance on the diagnosis and clinical management of dermatologic symptoms associated with sorafenib in patients with advanced solid tumors.

Methods: English-language studies representative of a patient population with a variety of tumor types, who received single-agent sorafenib, were selected. Particular emphasis was placed on the phase III Treatment Approaches in Renal Cancer Global Evaluation Trial (TARGETs).

Results: Frequently observed dermatologic side effects (any grade in TARGETs) of sorafenib include rash/desquamation (40%), hand-foot skin reaction (30%), alopecia (27%), and pruritus (19%). Generally, dermatologic symptoms resolve with appropriate management, including topical treatments, dose interruptions, dose reductions, or a combination of these.

Limitations: The results presented here are based on a limited number of studies.

Conclusion: Although sorafenib is associated with dermatologic symptoms, these are usually resolved with appropriate intervention, patient-led practical treatment, and preventative measures.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Benzenesulfonates / administration & dosage
  • Benzenesulfonates / adverse effects*
  • Humans
  • Neoplasms / drug therapy*
  • Niacinamide / analogs & derivatives
  • Phenylurea Compounds
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / adverse effects*
  • Pyridines / administration & dosage
  • Pyridines / adverse effects*
  • Skin Diseases / chemically induced*
  • Sorafenib


  • Antineoplastic Agents
  • Benzenesulfonates
  • Phenylurea Compounds
  • Protein Kinase Inhibitors
  • Pyridines
  • Niacinamide
  • Sorafenib