Sorafenib-Associated Heart Failure Complicated by Cardiogenic Shock after Treatment of Advanced Stage Hepatocellular Carcinoma: A Clinical Case Discussion

Figure 5

Sorafenib inhibits multiple tyrosine kinase and second messenger pathways. In the cardiac myocyte, inhibition of prosurvival pathways RAS/MAPK via BRAF and P13K/AKT1 via VEGFR leads to diminished survival. Sorafenib further inhibits RAF1, which leads to loss of tonic inhibition of cell death pathways and death through activation of caspases.