Shioya Makoto, Nishimura Takashi, Nishida Atsushi, Inatomi Osamu, Bamba Shigeki, Sasaki Masaya, Andoh Akira, Fujiyama Yoshihide
Division of Gastroenterology, Department of Internal Medicine, Shiga University of Medical Science.
Nihon Shokakibyo Gakkai Zasshi. 2014 Jul;111(7):1424-32.
Erythema multiforme (EM) is a known side effect of sorafenib therapy in cancer patients; at onset, the causative medication should be permanently discontinued. Here we report two cases of hepatocellular carcinoma (HCC) that developed sorafenib-induced EM. In both cases, retreatment with sorafenib combined with steroid therapy achieved effective tumor control without EM recurrence. The first patient was a 72-year-old woman who showed a dramatic response to sorafenib retreatment, with complete remission after 8 months of therapy. There was no rash recurrence after the steroid dose was gradually tapered and stopped. The second patient was a 69-year-old man who responded to sorafenib and exhibited stable disease, with no recurrence of the rash after the steroid dose was tapered. However, mild hand-foot syndrome persisted throughout sorafenib therapy. Although sorafenib should be discontinued if EM occurs, if there is no suitable alternative treatment, retreatment may be considered with steroid cover in patients with unresectable HCC.