Abstract
Epithelioid sarcoma affects three in 10 million people, usually teenagers and young adults. Tumours grow under the skin of the extremities or they can affect the trunk, head, or neck. It grows slowly, but can infiltrate surrounding tissues, later on, it frequently metastasis to lymph nodes. For advanced case, doxorubicin-based chemotherapy regimen is recommended. In January 2020, FDA approved the first-in-class, small molecule enhancer of zeste homolog 2 (EZH2) inhibitor, tazemetostat (Tazverik) to treat adults and paediatric patients aged 16 years and older with locally advanced or metastatic epithelioid sarcoma not suitable for complete resection. The recommended dosage is 800 mg twice daily until disease progression or unacceptable toxicity. The first-in-human study of tazemetostat was a phase 1 open-label multi-centered dose-escalation study. Tazemetostat is having an oral bioavailability of approximately 33%. Apparent volume of distribution at steady state (Vss/F) is 1230 L (46%) with 88% bound to human plasma proteins. Metabolism takes place via CYP3A. 15% and 79% of radioactivity is excreted through urine and feces respectively. ≥ 20% of the adverse reactions and above was fatigue, pain, constipation, nausea, anorexia and vomiting. This article summarizes the history, chemistry, physical properties, mechanism of action, indications, and drug–drug interactions of tazemetostat and we also discuss briefly the results of various clinical trials.
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References
Czarnecka, A. M., Sobczuk, P., Kostrzanowski, M., Spalek, M., Chojnacka, M., Szumera-Cieckiewicz, A., Rutkowski, P. 2020. Epithelioid Sarcoma— From Genetics to Clinical Practice. Cancers, 12(8):2112–2112.
Enzinger, F. M. 1970. Epithelioid sarcoma.A sarcoma simulating a granuloma or a carcinoma. Cancer, 26(5):1029–1041.
Epizyme Inc 2020. Tazverik (tazemetostat) tablets, for oral use: US prescribing information. Pg: 1-15, Accessed on 10 Oct 2020.
Gounder, M., Schöffski, P., Jones, R. L., Agulnik, M., Cote, G. M., Villalobos, V. M., Attia, S., Chugh, R., Chen, T. W.-W., Jahan, T., Loggers, E. T., Gupta, A., Italiano, A., Demetri, G. D., Ratan, R., Davis, L. E., Mir, O., Dileo, P., Tine, B. A. V., Pressey, J. G., Lingaraj, T., Rajarethinam, A., Sierra, L., Agarwal, S., Stacchiotti, S. 2020. Tazemetostat in advanced epithelioid sarcoma with loss of INI1/SMARCB1: an international, open-label, phase 2 basket study. The Lancet Oncology, 21(11):1423–1432.
Hoy, S. M. 2020. Tazemetostat: First Approval. Drugs, 80(5):513–521.
Italiano, A., Soria, J.-C., Toulmonde, M., Michot, J.- M., Lucchesi, C., Varga, A., Coindre, J.-M., Blakemore, S. J., Clawson, A., Suttle, B., McDonald, A. A., Woodruff, M., Ribich, S., Hedrick, E., Keilhack, H., Thomson, B., Owa, T., Copeland, R. A., Ho, P. T. C., Ribrag, V. 2018. Tazemetostat, an EZH2 inhibitor, in relapsed or refractory B-cell non-Hodgkin lymphoma and advanced solid tumours: a first-in- human, open-label, phase 1 study. The Lancet Oncology, 19(5):649–659.
Leslie, M. 2020. First EZH2 inhibitor approved-for rare sarcoma. Cancer discovery, 10(3):333–334.
Morschhauser, F., Tilly, H., Chaidos, A., McKay, P., Phillips, T., Assouline, S., Batlevi, C. L., Campbell, P., Ribrag, V., Damaj, G. L., Dickinson, M., Jurczak, W., Kazmierczak, M., Opat, S., Radford, J., Schmitt, A., Yang, J., Whalen, J., Agarwal, S., Adib, D., Salles,
G. 2020. Tazemetostat for patients with relapsed or refractory follicular lymphoma: an open-label, single-arm, multicentre, phase 2 trial. The Lancet Oncology, 21(11):1433–1442.
Ribrag, V., Morschhauser, F., McKay, P., Salles, G. A., Batlevi, C. L., Schmitt, A., Tilly, H., Cartron, G., Thieblemont, C., Fruchart, C., Gribben, J. G., Lamy, T., Gouill, S. L., Bouabdallah, R., Dickinson, M., Opat, S., Adib, D., Blakemore, S. J., Larus, J., Johnson, P. 2018. Interim Results from an Ongoing Phase 2 Multicenter Study of Tazemetostat, an EZH2 Inhibitor, in Patients with Relapsed or Refractory (R/R) Diffuse Large B-Cell Lymphoma (DLBCL). Blood, 132(Supplement 1):4196–4196.
Stacchiotti, S., Blay, J. Y., Jones, R. L., Demetri, G. D. D., Mir, O., Italiano, A., Jahan, T. 2018. 1611PD A phase II, multicenter study of the EZH2 inhibitor tazemetostat in adults (INI1-negative tumors cohort)(NCT02601950). Annals of Oncology, 29(suppl_8):299–310.
Stacchiotti, S., Schoffski, P., Jones, R., Agulnik, M., Villalobos, V. M., Jahan, T. M., Chen, T. W.-W., Italiano, A., Demetri, G. D., Cote, G. M., Chugh, R., Attia, S., Gupta, A. A., Loggers, E. T., Tine, B. V., Sierra, L., Yang, J., Rajarethinam, A., Gounder, M. M. 2019. Safety and efficacy of tazemetostat, a first-in-class EZH2 inhibitor, in patients (pts) with epithelioid sarcoma (ES) (NCT02601950). Journal of Clinical Oncology, 37(15_suppl):11003–11003.
Thway, K., Jones, R. L., Noujaim, J., Fisher, C. 2016. Epithelioid sarcoma: diagnostic features and genetics. Advances in anatomic pathology, 23(1):41–49.
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