Use of Tazemetostat in R/R FL

Cancer Network has a new video series on Follicular Lymphoma. You all know I like these kinds of things, since they usually involve a Lymphoma expert giving their take on what is happening in the world of Lymphoma research. I enjoy watching an expert talk about what they think is exciting.

This series features Dr. Connie Batlevi from Memorial Sloan Kettering Cancer Center in New York. (Dr. Batlevi is a "double doctor" -- she has an MD and a PhD, which I always find impressive as heck. Not only smart, but willing to stick with two programs.)

What I found most interesting about the series is video #3, "Use of Tazemetostat in R/R FL." That link will take you to the video series, which includes transcripts, in case anyone wants to read and/or translate the text.

When Tazemetostat was approved for Relapsed/Refractory Follicular Lymphoma last year, I was kind of unimpressed with the numbers, and a little unsure of why everyone was so excited about it. It seemed like a relatively small number of patients would benefit from it. And the company that makes Tazemetostat was fairly aggressive in marketing it; I was seeing ads for it all over the place.

(And before I go on, this is a good time to remind everyone that I am not a doctor or a cancer researcher. I'm a patient who reads a lot and tries to stay informed. So when I say I was "unimpressed with the numbers," take that for what it's worth. An informed opinion, but not an expert opinion.)

The video does a good job of explaining why Tazemetostat is something to be excited about.

Tazemetostat is an EZH2 inhibitor. We know that inhibitors work by inhibiting things -- stopping something from doing what it wants to do. In this case, it stops EZH2, an enzyme that is involved with winding and unwinding DNA, and helping cancerous B cells to grow. So inhibiting, or stopping EZH2 will help stop FL cells from growing. (I think Dr. Batlevi does a very good job of explaining this.)

Not every FL patient has mutated EZH2, and Tazemetostat works best on the 25% or so of FL patients that do have this mutation -- about 70% of those patients had a response, and about 20% of those had a durable response, one that lasted more than 18 months. About 35% of patients with a "wild type" EZH2 had a response, with about 20% of those having the same 18 month response.

So why the excitement? Two reasons.

First, as Dr. Betlavi explains, Tazemetostat is one of the first truly targeted treatments for FL. There needs to be some genetic testing to figure out if the patient has mutated EZH2. Having a treatment that uses this kind of approach successfully "opens doors in terms of how we can use genetic profiling and personalized medicine to do more treatments in lymphoma," as she says. That happens a lot -- someone shows that a particular approach works, and other researchers build on that approach in new ways. 

The other important thing is that Tazemetostat has a good safety profile -- there aren't many side effects, and those that exist aren't too severe. That makes it a good candidate for combination with other treatments. If two treatments kill cancer cells in different ways, and their combined side effects aren't too harsh, then we may have a treatment combination that is effective and helps maintain quality of life -- something very important in a cancer like FL that may involve many treatments over many years.

So it's a good video. I like video series like this because they usually reinforce what I know about FL, but this one was great because it taught me some new things.

And since I'm a non-cancer professional who shares my opinions about cancer, that's good for all of us.