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**sorafenib + levothyroxine** is a combination of two pharmaceutical drugs used primarily in the management of differentiated thyroid carcinoma (DTC) that is refractory to radioactive iodine. Sorafenib is a multikinase inhibitor targeting several kinases involved in cell proliferation, angiogenesis, and tumor progression, including RAF kinases, VEGFR, PDGFR, KIT, and FLT3, thereby exerting antineoplastic effects. Levothyroxine is a synthetic thyroid hormone that acts as a replacement therapy, mainly used for thyrotropin (TSH) suppression in thyroid cancer patients, which reduces stimulation of residual thyroid tissue and lowers the risk of cancer recurrence. The combination is primarily indicated for thyroid cancer patients who require TSH suppression and are receiving sorafenib for progressive, locally recurrent or metastatic disease. Pharmacokinetic studies in healthy volunteers indicate that short-term levothyroxine administration (14 days, 300 μg daily) does not significantly affect sorafenib pharmacokinetics or toxicity, and the regimen is generally well tolerated[1][2].
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