TAZVERIK 200 MG (TAZEMETOSTAT)

What is Tazverik?

Tazverik is used to treat adults and pediatric patients aged 16 years and older with advanced epithelioid sarcoma, a rare slow-growing type of soft tissue cancer. This medicine is used when the cancer has spread to other parts of the body (metastatic) or cannot be removed with surgery.

Tazverik is also used to treat follicular lymphoma when the disease has come back or did not respond to treatment in adults:

• 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.
• who have no other satisfactory treatment options.

🏥 Indications

1. Epithelioid Sarcoma

• FDA approved in January 2020 for metastatic or locally advanced epithelioid sarcoma not amenable to complete resection.

• Based on the phase II EZH‑202 trial with 62 patients (median age 34), showing:

  • ORR 15% (1.6% CR, 13% PR)

  • 67% of responders maintained response ≥6 months

2. Follicular Lymphoma

• Approved for relapsed or refractory follicular lymphoma in patients aged ≥ 16 years with EZH2 mutations who have received ≥2 prior therapies

💊 Dosage & Administration

• 800 mg orally twice daily (total 1600 mg/day), i.e., four 200 mg tablets

• Can be taken with or without food; tablets should be swallowed whole

Dose reductions for toxicity:

• Reduce to 600 mg BID, then 400 mg BID; discontinue if 400 mg BID intolerance persists

⚠️ Warnings & Precautions

• Secondary malignancies: Risk of MDS, AML (~0.6%), and T-cell lymphoblastic lymphoma. Long‑term follow-up is advised .

• Fetal toxicity: Pregnancy category – can cause fetal harm; requires non-hormonal contraception for:

  • Women: during treatment and for 6 months after

  • Men: for 3 months after final dose .

• Drug Interactions: Avoid strong/moderate CYP3A4 inhibitors/inducers; hormonal contraceptives may be less effective .

• Hepatic/Renal impairment: No adjustment needed for mild-severe renal disease; not studied in moderate-severe hepatic impairment

⚕️ Side Effects

Very common (≥20%) in epithelioid sarcoma:

• Pain (52%), fatigue (47%), nausea (36%), decreased appetite (26%), vomiting (24%), constipation (21%)

Serious AEs (≥3%):

• Hemorrhage, pleural effusion, skin infections, dyspnea, and respiratory distress; 37% experienced serious AEs, with one permanent discontinuation due to altered mood

Additional patient counseling:

• Watch for signs of bleeding, bruising, infections, fatigue, and respiratory issues .

📝 Practical Use Notes

• Administration: Take consistently at the same times daily; if vomiting occurs post-dose, skip and continue schedule

• Diet: Avoid grapefruit and St John’s wort

• Monitoring: Periodic CBC, LFTs, infection surveillance, and secondary cancer screening.

✅ Conclusion

Tazverik (tazemetostat) offers a targeted oral option for two rare, EZH2-driven cancers: epithelioid sarcoma and follicular lymphoma. It provides durable responses for some patients, though risks include secondary malignancies, AEs like fatigue and GI symptoms, and significant drug interactions. Proper dose adjustments, contraception, and long-term monitoring are essential for safe use.