IMPORTANT SAFETY INFORMATION

NEXAVAR may cause birth defects or death of an unborn baby. Avoid becoming pregnant while taking NEXAVAR and for at least 2 weeks after stopping your treatment. Men and women should use birth control during and at least 2 weeks after NEXAVAR therapy. Call your doctor right away if you become pregnant. Do not breastfeed while taking NEXAVAR as this medication may be passed through breast milk. Before starting NEXAVAR, tell your doctor if you have allergies; heart problems or chest pain; bleeding or bruising problems. continue reading below »

The Stages of Liver Cancer

The first step your doctor will take in developing a treatment plan is determining the stage of your cancer. Staging is a medical term used to describe how far cancer has progressed based on its size and location. Staging is important because it helps your doctor determine which type of treatment to use.¹ There are a number of staging systems for liver cancer. One system uses Roman numerals I through IV:

Below are definitions of some terms used to describe the stages of liver cancer:

Localized resectable—The tumor is located in one part of the liver and can be surgically removed (resected)

Localized unresectable—The cancer is in one part of the liver but cannot be surgically removed either because of where it is or because the rest of the liver is not healthy enough

Advanced—The cancer has spread to more than one part of the liver and possibly to other parts of the body

Recurrent—Cancer has come back to the liver or to another part of the body after a treatment such as surgery or liver transplantation

It's not unusual for liver cancer to be diagnosed at more advanced stages, because many people don't have symptoms in the early stages of the disease.^1,3,4

Indication

NEXAVAR is an anticancer medicine used to treat a certain type of kidney cancer called advanced renal cell carcinoma (RCC), or a certain type of liver cancer known as hepatocellular carcinoma (HCC), when it cannot be treated with surgery.

Important Safety Information

Do not take Nexavar if you have a specific type of lung cancer (squamous cell) and receive carboplatin and paclitaxel. Before starting NEXAVAR, tell your doctor if you have: allergies; heart problems (including a problem called congenital long QT syndrome) or chest pain; bleeding or bruising problems; high blood pressure; or kidney or liver problems. NEXAVAR may interact with certain other medicines so tell your doctor about all medicines you take including prescription and over-the-counter (OTC) medicines, vitamins, or herbal supplements. It is especially important to tell your doctor if you take warfarin (Coumadin).

NEXAVAR may cause serious side effects, including:

– decreased blood flow to the heart and heart attack. Get emergency help if you have chest pain, shortness of breath, feel lightheaded or faint, have nausea or vomiting, or you are sweating a lot.
– bleeding problems. Tell your doctor if you have any bleeding or easy bruising while taking NEXAVAR.
– high blood pressure. Your blood pressure should be checked every week during the first 6 weeks of starting therapy and then regularly, thereafter. If your blood pressure is high, it may need to be treated.
– a skin problem called hand-foot skin reaction. This causes redness, pain, swelling or blisters on the palms of your hands and soles of your feet. Your doctor may change your dose or stop treatment for a while.
– perforation of the bowel. Tell your doctor right away if you get high fever, nausea, vomiting or abdominal pain.
– wound healing problems. If you have a surgical or dental procedure, tell your doctor you are taking NEXAVAR. Your treatment may be stopped until after your surgery or until your wound heals.
– changes in the electrical activity of your heart called QT prolongation. QT prolongation can cause irregular heartbeats that can be life-threatening. Tell your doctor right away if you feel faint, lightheaded, dizzy, or feel your heart beating irregularly or fast while taking Nexavar.

The most common side effects with NEXAVAR may include: rash, redness, itching or peeling skin; hair thinning or loss; diarrhea; nausea/vomiting; mouth sores; weakness; loss of appetite; numbness, tingling or pain in hands and feet; abdominal pain; tiredness; or weight loss. Tell your doctor if you have any side effects that bother you or do not go away.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1.800.FDA.1088. For important risk and use information, please see the patient prescribing information.

References: 1. Llovet JM. Updated treatment approach to hepatocellular carcinoma. J Gastroenterol. 2005;40(3):225-235. 2. National Comprehensive Cancer Network, Inc. The NCCN Clinical Practice Guidelines in Oncology. Hepatobiliary Cancers (Version 2.2009). NCCN Web site http://www.nccn.org. Accessed July 24, 2009. 3. Dienstag JL, Isselbacher KJ. Tumors of the liver and biliary tract. In: Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, eds. Harrison's Principles of Internal Medicine. 16th ed. New York, NY: McGraw-Hill Medical Publishing Division; 2005:533-536. 4. Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet. 2003;362(9399):1907-1917.