HEALTH PROFESSIONAL · SOURCE READING
Sorafenib
Source: Thyroid Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: May 9, 2025 · Captured 2026-09-09.
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Sorafenib is an orally active, multitargeted tyrosine kinase inhibitor. The U.S. Food and Drug Administration (FDA) approved sorafenib as a treatment option when recurrent disease does not concentrate 131I or disease recurs after 131I ablation.
Evidence (sorafenib):
A phase III, randomized, double-blind, placebo-controlled study (DECISION [NCT00984282]) evaluated sorafenib in patients with progressive, iodine-refractory, differentiated thyroid cancer.[21] This trial included 417 patients with locally advanced or metastatic RAI-refractory thyroid cancer (papillary, follicular [including Hürthle cell], and poorly differentiated tumors) whose disease had progressed within the past 14 months. Patients were randomly assigned to receive either sorafenib (400 mg twice a day) or placebo. Patients who received previous chemotherapy, thalidomide, or targeted therapy were excluded.[21][Level of evidence B1]
Source links and citations
A phase III, randomized, double-blind, placebo-controlled study (DECISION [NCT00984282]) evaluated sorafenib in patients with progressive, iodine-refractory, differentiated thyroid cancer.[21] This trial included 417 patients with locally advanced or metastatic RAI-refractory thyroid cancer (papillary, follicular [including Hürthle cell], and poorly differentiated tumors) whose disease had progressed within the past 14 months. Patients were randomly assigned to receive either sorafenib (400 mg twice a day) or placebo. Patients who received previous chemotherapy, thalidomide, or targeted therapy were excluded.[21][Level of evidence B1]
The median PFS was 10.8 months in the sorafenib group and 5.8 months in the placebo group (HR, 0.59; 95% CI, 0.45–0.76; P < .001).
A phase III, randomized, double-blind, placebo-controlled study (DECISION [NCT00984282]) evaluated sorafenib in patients with progressive, iodine-refractory, differentiated thyroid cancer.[21] This trial included 417 patients with locally advanced or metastatic RAI-refractory thyroid cancer (papillary, follicular [including Hürthle cell], and poorly differentiated tumors) whose disease had progressed within the past 14 months. Patients were randomly assigned to receive either sorafenib (400 mg twice a day) or placebo. Patients who received previous chemotherapy, thalidomide, or targeted therapy were excluded.[21][Level of evidence B1]
OS was not significantly improved (HR, 0.80; 95% CI, 0.54–1.19; one-sided P = .14), but the median OS had not been reached at the time of primary analysis data cutoff, and crossover was allowed.
A phase III, randomized, double-blind, placebo-controlled study (DECISION [NCT00984282]) evaluated sorafenib in patients with progressive, iodine-refractory, differentiated thyroid cancer.[21] This trial included 417 patients with locally advanced or metastatic RAI-refractory thyroid cancer (papillary, follicular [including Hürthle cell], and poorly differentiated tumors) whose disease had progressed within the past 14 months. Patients were randomly assigned to receive either sorafenib (400 mg twice a day) or placebo. Patients who received previous chemotherapy, thalidomide, or targeted therapy were excluded.[21][Level of evidence B1]
Objective response rates (all partial responses) were 12.2% in the sorafenib group and 0.5% in the placebo group.
A phase III, randomized, double-blind, placebo-controlled study (DECISION [NCT00984282]) evaluated sorafenib in patients with progressive, iodine-refractory, differentiated thyroid cancer.[21] This trial included 417 patients with locally advanced or metastatic RAI-refractory thyroid cancer (papillary, follicular [including Hürthle cell], and poorly differentiated tumors) whose disease had progressed within the past 14 months. Patients were randomly assigned to receive either sorafenib (400 mg twice a day) or placebo. Patients who received previous chemotherapy, thalidomide, or targeted therapy were excluded.[21][Level of evidence B1]
Median time-to-progression was 11.1 months in the sorafenib group and 5.7 months in the placebo group (HR, 0.56; 95% CI, 0.43–0.72; P < .001).
A phase III, randomized, double-blind, placebo-controlled study (DECISION [NCT00984282]) evaluated sorafenib in patients with progressive, iodine-refractory, differentiated thyroid cancer.[21] This trial included 417 patients with locally advanced or metastatic RAI-refractory thyroid cancer (papillary, follicular [including Hürthle cell], and poorly differentiated tumors) whose disease had progressed within the past 14 months. Patients were randomly assigned to receive either sorafenib (400 mg twice a day) or placebo. Patients who received previous chemotherapy, thalidomide, or targeted therapy were excluded.[21][Level of evidence B1]
Adverse events occurred in 98.6% of patients treated with sorafenib and 87.6% of patients treated with placebo. The most common adverse events in the sorafenib group were hand-foot skin reactions (76.3%), diarrhea (68.6%), alopecia (67.1%), and rash or desquamation (50.2%). Most events were grade 1 or 2. Seven squamous cell carcinomas of the skin occurred in the sorafenib group.
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