Managing a Typically Incurable Blood Cancer
Cancer can affect anyone regardless of age, lifestyle, or geographical location. Whether you or a loved one receives this diagnosis, feelings of surprise and shock are common, especially for those who may not have experienced symptoms at the time of diagnosis.
One type of cancer that is often asymptomatic is follicular lymphoma, a slow-growing, typically incurable form of blood cancer called non-Hodgkin’s lymphoma. In follicular lymphoma, a gene called EZH2 becomes overactive and plays a key role in causing follicular lymphoma in all patients. The symptoms of follicular lymphoma include swelling of lymph nodes in the neck, underarms, abdomen, or groin, as well as fatigue. Less common symptoms include fever, night sweats, and weight loss. While follicular lymphoma can be diagnosed at any age, the average age at diagnosis is 60 years old.
“Follicular lymphoma can present differently in patients – some may have a slow-growing cancer, while others may need treatment immediately, and see their follicular lymphoma return,” says Dr. Ahmed Galal, who sees patients with follicular lymphoma at Duke Cancer Institute in Durham, North Carolina. “What’s important to keep in mind though, is that follicular lymphoma is considered a chronic disease because it is typically incurable, although patients can live for many years with it.”
Follicular lymphoma treatments vary, depending on the stage of the disease, a patient’s treatment history and other factors. After an initial round of treatment, patients often experience a period of remission before the disease returns, also known as a relapse. Upon discovery that a patient’s cancer has returned, their doctor will make recommendations for the next course of treatment, taking multiple factors into consideration (e.g., length of time between treatments and lifestyle needs) to find a treatment that is both effective and tolerable, which will allow the patient to remain on therapy. When patients relapse, their physician may find their cancer has become resistant to treatments they have received before, and new treatment options are needed.
“Patients should work closely with their doctors to identify a treatment approach that works best for their individual needs,” says Dr. Galal. “It’s important to understand that follicular lymphoma treatment is not ‘one and done.’ The great news is, the treatment landscape for follicular lymphoma has evolved rapidly in the last decade, leading to better outcomes for patients. It’s important to discuss these options and weigh which approach will work best for you.”
One available treatment option is TAZVERIK® (tazemetostat). TAZVERIK is approved by the U.S. Food and Drug Administration (FDA) to treat adults with follicular lymphoma when the disease has come back or did not respond to treatment, whose tumors have an abnormal EZH2 gene, and who have been treated with at least two prior medicines, or who have no other satisfactory treatment options. Overactive EZH2 plays a key role in causing follicular lymphoma in all patients (with or without an EZH2 mutation). Whether or not you have the mutation, TAZVERIK may help shrink your tumors if your follicular lymphoma has come back or treatment hasn’t worked.
The approval of TAZVERIK in these patients is based on a study that measured the percentage of patients whose tumor shrank or disappeared after treatment and the length of their response. TAZVERIK is still being studied to confirm these benefits. It is not known whether TAZVERIK is safe and effective in children less than 16 years of age. TAZVERIK is associated with side effects and may not be suitable for every patient. Since everyone may react differently to treatment, it is important for patients to talk to their doctor about whether a specific treatment may work for them.
TAZVERIK is an oral treatment, which can be taken at home. Many patients prefer an oral option, as it can be tiresome to travel to infusion centers and sit for hours in a chair to receive treatment.
For more information on TAZVERIK, including full Prescribing Information and Medication Guide, please visit tazverik.com.
Donna Johnson’s Story
After experiencing a strange cramp in her calf that would not go away, Donna Johnson, a patient of Dr. Galal’s, decided to mention it during a routine medical checkup. A series of tests revealed that the cramp was an enlarged lymph node and Donna was ultimately diagnosed with non-Hodgkin’s lymphoma in early 2015. At that time, Johnson worked with her doctor to develop a plan and underwent successful treatment.
When the same cramp returned in 2017, Johnson had a feeling the cancer was back. A follow-up scan showed that her cancer had reappeared, and this time it was follicular lymphoma. Again, Johnson underwent successful treatment, but, her cancer came back again for a third time in 2019. She’s still being actively treated for follicular lymphoma today.
“I visit my doctor’s office in person every three months, but I can reach out to my healthcare team anytime for questions via email or a call,” Johnson says. “I encourage everyone currently managing cancer, and especially others with follicular lymphoma, to find a doctor they are comfortable with and to be your own advocate—ask questions, don’t be afraid to speak up when you feel something is wrong, and keep living life with a positive attitude.”
Throughout her diagnosis and treatment journey, Donna has been comforted by a great support system at home – when she was first diagnosed, her husband bought a blender and learned to make her smoothies since the nurse said she should be getting a lot of vegetables. Donna’s husband is still making smoothies for her all these years later.
What is TAZVERIK?
TAZVERIK is a prescription medicine used to treat:
- Adults with follicular lymphoma when the disease has come back or did not respond to treatment, whose tumors have an abnormal EZH2 gene, and who have been treated with at least two prior medicines. Your healthcare provider will perform a test to make sure TAZVERIK is right for you.
- Adults with follicular lymphoma when the disease has come back or did not respond to treatment, who have no other satisfactory treatment options.
The approval of TAZVERIK in these patients is based on a study that measured the percentage of patients whose tumor shrank or disappeared after treatment and how long that response lasted. TAZVERIK is still being studied to confirm these benefits.
It is not known if TAZVERIK is safe and effective in children less than 16 years of age.
Important Safety Information
What is the most important information I should know about TAZVERIK?
TAZVERIK can cause serious side effects, including:
- Risk of new cancers. An increase in new (second) cancers has happened in people who were treated with TAZVERIK. Talk with your healthcare provider about your risk of developing new cancers. Your healthcare provider will monitor you for new cancers after your treatment with TAZVERIK. Tell your healthcare provider if you are more tired than usual, or have easy bruising, fever, bone pain, or paleness.
Before taking TAZVERIK tell your healthcare provider about all of your medical conditions, including if you:
- Are pregnant or plan to become pregnant. TAZVERIK can harm your unborn baby. Your healthcare provider will give you a pregnancy test before you start treatment with TAZVERIK. Tell your healthcare provider right away if you become pregnant or think you may be pregnant.
- Females who are able to become pregnant should use effective non-hormonal birth control (such as condoms) during treatment and for 6 months after the final dose of TAZVERIK. Birth control pills (oral contraceptives) and other hormonal forms of birth control may not be effective if used during treatment with TAZVERIK. Talk to your healthcare provider about birth control options that are right for you.
- Males with female partners who are able to become pregnant should use effective birth control during treatment and for 3 months after the final dose of TAZVERIK.
- Are breastfeeding or plan to breastfeed. It is not known if TAZVERIK passes into your breast milk. Do not breastfeed during treatment and for 1 week after the final dose of TAZVERIK.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. TAZVERIK may affect the way other medicines work and other medicines may affect how TAZVERIK works.
What should I avoid while taking TAZVERIK?
- Avoid eating grapefruit or drinking grapefruit juice during treatment with TAZVERIK.
- Avoid taking St. John’s wort during treatment with TAZVERIK.
Talk to your healthcare provider before starting any new medications or supplements.
What are the possible side effects of TAZVERIK?
The most common side effects of TAZVERIK in people with follicular lymphoma include:
- Cold-like symptoms (upper respiratory infection)
- Bone and muscle pain
- Stomach (abdominal pain)
These are not all the possible side effects of TAZVERIK.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Please see full Prescribing Information for TAZVERIK and Medication Guide, available at www.tazverik.com.