Sorafenib in Treating Patients With Advanced Anaplastic Thyroid Cancer

Criteria:

* Progressive disease after prior cytotoxic chemotherapy (i.e., chemotherapy alone or combined with radiotherapy)
* No symptomatic bulky disease that would impair the airway or impede swallowing (for patients with ECOG performance status 2)
* No known brain metastases
* Measurable or evaluable disease

  * Measurable disease, defined as ≥ 1 unidimensionally measurable lesion \>= 20 mm by conventional techniques OR \>= 10 mm by spiral CT scan
  * Measurable disease not in a previously irradiated field
* Patients with evidence of abnormal cardiac conduction (e.g., bundle branch block or heart block) are eligible provided disease has been stable for the past 6 months
* Performance status:

  * ECOG 0-2 OR Karnofsky 50-100%
* Life expectancy more than 8 weeks
* Absolute neutrophil count \>= 1,250/mm3
* Platelet count \>= 100,000/mm3
* No evidence of bleeding diathesis
* Bilirubin =\< 1.5 times upper limit of normal (ULN)
* PTT =\< 1.5 times ULN
* Creatinine =\< 1.5 times ULN
* No myocardial infarction within the past 6 months
* No New York Heart Association class III or IV cardiac disease
* No symptomatic congestive heart failure
* No unstable angina pectoris
* No uncontrolled hypertension (i.e., systolic blood pressure (BP) \> 150 mm Hg OR diastolic BP \> 100 mm Hg)
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* Able to swallow oral medication
* No history of allergic reactions attributed to compounds of similar chemical or biological composition to sorafenib
* No ongoing or active infection
* No psychiatric illness or social situation that would preclude study compliance
* No other invasive malignancy within the past 5 years except nonmelanoma skin cancer
* No other uncontrolled illness
* No more than 2 prior systemic cytotoxic chemotherapy regimens (combined modality systemic cytoxic chemotherapy is considered 1 prior cytotoxic regimen)
* At least 7 days since prior chemotherapy and recovered
* At least 7 days since prior radiotherapy and recovered
* No prior sorafenib or other inhibitors of MAP kinase signaling intermediates
* No prior cancer treatment that would preclude study participation
* No concurrent combination antiretroviral therapy for HIV-positive patients
* No other concurrent investigational agents
* No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (e.g., phenytoin, carbamazepine, or phenobarbital)
* No concurrent Hypericum perforatum (St. John's wort) or rifampin
* No concurrent therapeutic anticoagulation (concurrent prophylactic anticoagulation (i.e., low-dose warfarin) for venous or arterial access devices allowed provided requirements for INR and PTT are met)
* No other concurrent anticancer therapy
* Histologically confirmed anaplastic\* thyroid cancer

  * Not amenable to definitive curative surgery or radiotherapy \[Note: \*Papillary, follicular, or other histologies that are mixed or identified in a diagnostic tissue sample are allowed provided a high-grade undifferentiated anaplastic component is present \]
* No cardiac arrhythmia
* AST and ALT =\< 3.5 times ULN
* INR \< 2.0