Systemic therapies, such as chemotherapy, are delivered throughout your body through your bloodsteam. For liver cancer, systemic therapy is typically reserved for people with hepatocellular carcinoma who are unlikely to benefit from surgery or more local liver-directed treatments.
Traditional chemotherapy has typically proven ineffective against hepatocellular carcinoma and too toxic for patients. But an oral medication named sorafenib (Nexavar) has been shown to improve survival in people with advanced disease whose liver function is not dramatically impaired. This is the only systemic agent clearly shown to have such benefit in people with advanced hepatocellular carcinoma.
Sorafenib, which is available to Seattle Cancer Care Alliance (SCCA) patients, interferes with the signals that promote cancer growth. While not typically curative, it can temporarily halt or slow the progression of the disease. The duration of benefit varies.
Side effects of sorafenib vary from person to person and may include fatigue, diarrhea, inflammation of the skin on the hands and feet, and others. Let your medical oncology team know about any side effects you experience. They can help manage these effects, as needed, by giving you supportive medications and by adjusting your dose. To help minimize skin inflammation, you can prepare for treatment by applying moisturizing lotions to your hands and feet twice a day. For general advice about side effects that are common during cancer treatment, see the symptom management section.
Sorafenib is being studied in combination with liver-directed therapy in clinical studies, also called clinical trials. In addition, multiple promising experimental medications are being studied in eligible patients whose disease has progressed after a trial of sorafenib. Your SCCA team can tell you more about any systemic therapies that might be appropriate for you.