Tazemetostat is an EZH2 methyltransferase inhibitor primarily used to treat tumors with specific gene mutations. Its indications include epithelioid sarcoma and follicular lymphoma, and medication should pay attention to blood toxicity, embryonic risk, and drug interactions.

1. Indications

(1) Epithelioid sarcoma: suitable for patients aged 16 years and above with metastatic or locally advanced epithelioid sarcoma that cannot be completely resected, requiring FDA approved testing to confirm INI1/SMARCB1 deficiency.

(2) Follicular lymphoma: Used to treat adult patients with recurrent or refractory follicular lymphoma, it requires confirmation of EZH2 activation mutation through testing and at least 2 systemic treatments.

2. Medication precautions

(1) Hematological toxicity: May cause anemia, thrombocytopenia, and neutropenia. Regular monitoring of blood routine is necessary, and in severe cases, medication should be suspended or reduced.

(2) Secondary malignant tumors: Animal studies have shown that there may be an increased risk of malignant tumors, and new signs of tumors need to be monitored during medication.

(3) Embryo fetal toxicity: There is a risk of teratogenicity, and patients of childbearing age should take effective contraceptive measures during treatment and within 6 months after the last dose.

(4) Drug interactions: Avoid combination with potent CYP3A4 inducers or inhibitors as it may affect drug metabolism and efficacy.

(5) Liver function impairment: Patients with moderate to severe liver function impairment need to adjust the dosage, and it is recommended to monitor liver function at baseline and during treatment.

3. Medication for special populations

(1) Pediatric patients: Safety and efficacy have not been established for patients under the age of 16, and are limited to specific indications for patients aged 16 and above.

(2) Elderly patients: No significant differences were observed in clinical studies compared to younger patients, but individualized evaluation is needed.

(3) Breastfeeding period: It is recommended to stop taking medication or breastfeeding as medication may be secreted into breast milk.