Follicular lymphoma is a common type of low-grade non-Hodgkin lymphoma. Although treatment is usually successful, it is common for the lymphoma to come back (relapse) in the future and need more treatment.
A recent phase 2 trial looked at whether a new treatment called tazemetostat might be effective for people with relapsed or refractory follicular lymphoma. Initial results of the trial were presented at the International Conference for Malignant Lymphoma (ICML) in June 2017. Final results were published in the Lancet Oncology this month.
Tazemetostat is the first in a new class of drugs called EZH2 inhibitors. EZH2 is a protein that can turn off particular genes in cells. If EZH2 is too active, it can cause the cells to grow out of control and develop into cancer. Around 1 in 5 people with follicular lymphoma have a mutation in the gene that makes EZH2 (the EZH2 gene), which can make the EZH2 protein more active. Blocking the EZH2 protein with an EZH2 inhibitor might help to stop the lymphoma cells from growing.
In this trial, 99 people with relapsed or refractory follicular lymphoma were treated with tazemetostat tablets twice a day. Of these people, 45 had an EZH2 mutation.
The trial found that tazemetostat produced clinically meaningful and durable responses in people with follicular lymphoma who had already had at least two previous courses of treatment. The response rate was higher in people who had an EZH2 mutation than in people who did not have an EZH2 mutation.
Tazemetostat had a favourable safety profile. The most common side effects included sickness and diarrhoea, hair loss, fatigue, cough, fever and low blood counts.
The results of this early phase trial suggest that tazemetostat has promising efficacy for people with relapsed or refractory follicular lymphoma. Because it is well tolerated, it might also be suitable to use in combination with other treatments. This could be an exciting area for future studies.
26 November 2020