Bowel Perforation After Treatment with Sorafenib: A Case Report and Review of Literature

Sorafenib, one of the multitargeted tyrosine kinase inhibitors, is currently FDA approved for the treatment of advanced renal cell carcinoma (2005), unresectable hepatocellular carcinoma (2007), and differentiated thyroid carcinoma (2013) [1]. Prior studies have shown that bevacizumab therapy, a monoclonal antibody against vascular endothelial growth factor (VEGF), has significantly increased risk of gastrointestinal perforation with a relative risk of 2.14 (95 % CI 1.19–3.85; p=0.011) [2]. However, the association between gastrointestinal perforation and newer multitargeted tyrosine kinase inhibitors that inhibit other pathways in addition to VEGF is not well established [3]. We describe a case of bowel perforation in a patient on sorafenib and review the literature on similar cases.