Sorafenib Tosylate and Stereotactic Radiosurgery in Treating Patients With Brain Metastases

Inclusion Criteria:

* Histologically confirmed cancer with 1-4 brain metastases (except lymphoma or small cell histologies)
* ECOG PS 0 or 1
* Patients are candidates for stereotactic radiosurgery as determined by the treating radiation oncologist. Intra-cranial tumors must measure 4cm or less in greatest dimension. Patients may have received prior neurosurgical resection(s) of intra-cranial metastases if their operation(s) was (were) completed at least 6 months prior to study enrollment. Patients may have had prior whole brain radiation therapy (WBRT) if it was completed at least 6 months prior to study enrollment.
* Age ≥ 18 years and willing and able to sign a written informed consent; a signed informed consent must be obtained prior to any study specific procedures
* INR \< 1.5 or a PT/PTT within normal limits; patients receiving anti-coagulation treatment with an agent such as warfarin or heparin may be allowed to participate; for patients on warfarin, the INR should be measured prior to initiation of sorafenib and monitored at least weekly (INR must be therapeutic in the range of 2-3)

Subjects must receive 1st dose of sorafenib 5-7 days prior to administration of Stereotactic Radiosurgery.

Exclusion Criteria:

* Congestive heart failure \> class II NYHA; patients must not have unstable angina (anginal symptoms at rest) or new onset angina (began within the last 3 months) or myocardial infarction within the past 6 months
* Unable to undergo brain MRI
* CNS metastases from lymphoma or small cell lung cancer
* Cardiac ventricular arrhythmias requiring anti-arrhythmic therapy
* Uncontrolled hypertension defined as systolic blood pressure \> 140mm Hg or diastolic pressure \> 90 mm Hg, despite optimal medical management
* Known human immunodeficiency virus (HIV) infection or chronic Hepatitis B or C
* Active clinically serious infection \> CTCAE v 4.0 Grade 2
* Thrombolic or embolic events such as a cerebrovascular accident including transient ischemic attacks within the past 6 months
* Pulmonary hemorrhage/bleeding event \>= CTCAE v 3.0 Grade 2 within 4 weeks of first dose of study drug
* Any other hemorrhage/bleeding event \>= CTCAE v 3.0 Grade 3 within 4 weeks of first dose of study drug
* Serious non-healing wound, ulcer, or bone fracture
* Any drug that results in hepatic enzyme induction such as anti-convulsants (dilantin, depakote, tegretol, phenobarbital); keppra is allowed
* Evidence or history of bleeding diathesis or coagulopathy
* Any pulmonary hemorrhage CTCAE v 4.0 Grade 2 or higher within 4 weeks of first study drug
* Any other bleeding or hemorrhage CTCAE v 4.0 Grade 3 or higher within 4 weeks of first drug
* Major surgery, open biopsy or significant traumatic injury within 4 weeks of first study drug
* Use of St. John's Wort or rifampin (rifampicin) within the last 8 weeks
* Known or suspected allergy to sorafenib
* Any condition that impairs patient's ability to swallow whole pills
* Concurrent investigational drugs
* Concurrent steroids are allowed if Dexamethasone dose is =\< 16mg daily; if feasible, steroids should be weaned off once sorafenib has been initiated
* Prior therapy with sorafenib or other tyrosine kinase inhibitors within the last 12 months; patients are allowed to have been on prior bevacizumab therapy as long as it was stopped at least 6-8 weeks prior to enrolling on this trial
* Any malabsorption problem
* Hemoglobin =\< 9.0 g/dl
* Absolute neutrophil count (ANC) =\< 1,500/mm\^3
* Platelet count =\< 100,000/mm\^3
* Total bilirubin \>= 1.5 times upper limit of normal (ULN)
* ALT and AST \>= 2.5 times the ULN ( =\< 5 x ULN for patients with liver involvement)
* Creatinine \>= 1.5 times ULN
* Women of childbearing potential with a positive serum pregnancy test performed within 7 days prior to the start of treatment; women and men of childbearing potential that do not agree to use adequate contraception (barrier method of birth control) prior to study entry and for the duration of study participation; men who do not agree to use adequate birth control for at least three months after the last administration of sorafenib
* All toxicities from prior therapies must have resolved to CTCAE v3.0 Grade I or better by the time of study enrollment