Donafenib intolerance in hepatocellular carcinoma: severe hand-foot skin reaction and successful switch to lenvatinib - a case report and literature review.

ABSTRACT:

Background

Donafenib is an approved multikinase inhibitor for hepatocellular carcinoma (HCC). However, cutaneous toxicity-particularly hand-foot skin reaction (HFSR)-may necessitate treatment interruption and compromise therapeutic continuity.

Case presentation

A 58-year-old man with HCC on a cirrhotic background developed abrupt onset of intensely painful plantar erythema with overlying desquamation 10-11 days after initiating donafenib. The lesions rapidly progressed, leading to impaired ambulation and were consistent with CTCAE grade 3 HFSR.

Management and outcome

Donafenib was immediately discontinued, and the patient received short-term symptomatic management, resulting in prompt improvement of the acral lesions. He was subsequently transitioned to lenvatinib, wh

SUBMITTER: Chen Y 

PROVIDER: S-EPMC12756137 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature