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Systemic Anti-Cancer Therapy Regimen Library

LEU AML FLT3-ITD mutated - soRAFENib maintenance after allogeneic stem cell transplant

Treatment Overview

Sorafenib treatment commences between day +60 and day +100 for patients in complete haematological remission after allogeneic stem cell transplant. 

Cycle 1 - 28 days

Cycle length:
28

soRAFENib:

  • Cardiovascular risk factor assessment is recommended—consult prescribing information for details.
  • May prolong QTc interval and close monitoring is recommended. Avoid or reduce risk factors for QTc prolongation. Consult prescribing information.

Cycle 2 - 28 days

Cycle length:
28

Cycles 3 to 26 - 28 days

Cycle length:
28

Cycle details

Cycle 1 - 28 days

Medication Dose Route Days Max Duration
soRAFENib * 400 mg Once daily oral administration 1 to 14
soRAFENib * 600 mg Once daily oral administration 15 to 28

soRAFENib:

  • Cardiovascular risk factor assessment is recommended—consult prescribing information for details.
  • May prolong QTc interval and close monitoring is recommended. Avoid or reduce risk factors for QTc prolongation. Consult prescribing information.

Cycle 2 - 28 days

Medication Dose Route Days Max Duration
soRAFENib * 600 mg Once daily oral administration 1 to 14
soRAFENib * 400 mg Twice daily oral administration 15 to 28

Cycles 3 to 26 - 28 days

Medication Dose Route Days Max Duration
soRAFENib * 400 mg Twice daily oral administration 1 to 28

Full details

Cycle 1 - 28 days

Day: 1

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 2

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 3

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 4

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 5

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 6

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 7

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 8

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 9

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 10

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 11

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 12

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 13

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 14

Medication Dose Route Max duration Details
soRAFENib * 400 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 15

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 16

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 17

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 18

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 19

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 20

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 21

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 22

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 23

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 24

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 25

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 26

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 27

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 28

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Cycle 2 - 28 days

Day: 1

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 2

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 3

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 4

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 5

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 6

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 7

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 8

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 9

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 10

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 11

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 12

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 13

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 14

Medication Dose Route Max duration Details
soRAFENib * 600 mg Once daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 15

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 16

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 17

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 18

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 19

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 20

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 21

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 22

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 23

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 24

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 25

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 26

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 27

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 28

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Cycles 3 to 26 - 28 days

Day: 1

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 2

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 3

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 4

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 5

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 6

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 7

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 8

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 9

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 10

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 11

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 12

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 13

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 14

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 15

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 16

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 17

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 18

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 19

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 20

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 21

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 22

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 23

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 24

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 25

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 26

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 27

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Day: 28

Medication Dose Route Max duration Details
soRAFENib * 400 mg Twice daily oral administration
Instructions:

Swallow whole with a large glass of water.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Minimal to low
Irradiated blood components: Irradiation of blood components is recommended

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines. 

References

Burchert A, Bug G, Fritz LV, Finke J, et al. Sorafenib Maintenance After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia With FLT3-Internal Tandem Duplication Mutation (SORMAIN). J Clin Oncol. 2020 Sep 10;38(26):2993-3002. doi: 10.1200/JCO.19.03345. Epub 2020 Jul 16., PMID: 32673171

Bayer New Zealand Limited Nexavar data sheet 15 October 2020 https://medsafe.govt.nz/profs/Datasheet/n/Nexavartab.pdf (accessed 14 July 2022).

New Zealand Blood Service Transfusion Medicine Handbook Third Edition, 2016 https://www.nzblood.co.nz/assets/Transfusion-Medicine/PDFs/111G122.pdf (accessed 13/7/2022).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.