Maryann has always eaten well and exercised regularly. In early 2015, she began slowly gaining weight but chalked it up to a slowing metabolism — one consequence of getting older. Her former gynecologist was not too concerned. Then, overnight, she gained five pounds and the back pain that had been bothering her for a while became severe.
So, instead of taking the trip they’d planned for that Mother’s Day weekend, Maryann and her husband rushed to the local E.R. The hospital staff was unable to further diagnose Maryann’s condition and recommended she make an appointment to be seen that Monday. Worried, she contacted a friend who was the chief nurse at a nearby academic medical center. Maryann was transferred there, where she received her diagnosis: stage III ovarian cancer. She was 58-years-old and terrified.
Reflecting on her experience, Maryann says, “I knew something was not right.” She advises women to be their own advocates and speak up if they feel their concerns are being minimized. “I now realize that you're the one who knows your body best, and I wish I had pushed my former gynecologist harder for an explanation.”
Less than 24 hours after receiving her diagnosis, Maryann underwent surgery. She knew she was in good hands. “Both my surgeon and oncologist were highly recommended by my friend, and I liked them immediately,” says Maryann. “I think those first impressions are important,” she says. For her, finding the right team to support you during your treatment is key: “I think it’s important to immediately like your doctors. Do they make you feel comfortable? How do they treat you?”
Maryann soon learned how important it is to have an open dialogue with your doctors and stay educated about your treatment options. And when Maryann has shown up with a list of questions in hand, her doctors always take the time to answer every one and are impressed by her preparation.
Because oncology is such a dynamic field, it’s important for those impacted to keep abreast of and have conversations about advancements such as maintenance therapy. “Be prepared,” says Maryann. “If you’re not up for researching, find someone in your family who is, so you’re ready to ask your doctors the right questions.” For Maryann, that was her husband, who stepped into the role as soon as she was diagnosed.
Making the decision to go on maintenance therapy
Maryann was back to work less than two weeks after her discharge from the hospital, though she would take time off for chemotherapy at an infusion center. The center’s staff, patients and especially Maryann’s “caring” chemo nurse, became a supportive community for one another — what Maryann dubbed her “Friday Club.” “I think that was a big factor in helping me,” she says. “Having people you can lean on after a cancer diagnosis is important.” Friends and family helped Maryann stay positive, even during tough moments of her treatment.
“Life was happening. I was working. I was planning my daughter’s wedding: dress and venue shopping and hosting two showers,” says Maryann. While fatigue sometimes made things challenging, she rallied, knowing how important the event was to her daughter.
Unfortunately, Maryann experienced a recurrence of ovarian cancer in late 2016, a couple of months after her daughter’s wedding. Her experience is not uncommon — approximately 85% of women with advanced ovarian cancer will experience a recurrence in their lifetime.1
Maryann had no symptoms, but because she stuck to regular check-ups with her doctor, her monthly CA-125 blood test indicated her cancer had returned. She stresses that routine appointments after remission are critical for anyone with a cancer diagnosis. “Every time I left my doctor's office, I left with an appointment for the next month,” she says. When her cancer recurred, Maryann says she “was worried, of course.” But she had “complete confidence” in her oncologist. “She assured me the recurrence was treatable.”
Maryann underwent another course of chemotherapy. It was during this period that her husband learned about ZEJULA (niraparib, 100 mg capsules) as he was researching possible maintenance treatment options for recurrent ovarian cancer. At that time, ZEJULA was undergoing FDA review. ZEJULA is an oral drug known as a PARP-inhibitor, which may work by preventing cancer cells from repairing their damaged DNA, which can cause cancer cells to die and may slow the return or progression of cancer. ZEJULA can also affect other cells and tissues in the body.
Patients like Maryann who achieve complete or partial response to platinum-based chemotherapy may be eligible for maintenance therapy, which can potentially help delay the time before the cancer returns2. While Maryann is BRCA-positive, ZEJULA is an approved maintenance treatment option for eligible advanced ovarian cancer patients, regardless of whether a patient has the BRCA mutation or not. BRCA stands for BReast CAncer susceptibility gene and can be inherited from a parent.
ZEJULA, made by the pharmaceutical company GSK, is a prescription medicine used for the maintenance treatment of adults with advanced ovarian cancer, fallopian tube cancer or primary peritoneal cancer, whose cancer has responded (complete or partial response) to treatment with platinum-based chemotherapy. ZEJULA can be used when the cancer comes back. It can also be used in the “late-line setting,” for treatment of adults with advanced ovarian cancer, fallopian tube cancer or primary peritoneal cancer who have been treated with three or more prior types of chemotherapy and who have tumors with a certain BRCA gene mutation, or gene mutation problems who have progressed more than 6 months after their last treatment with platinum-based chemotherapy. For treatment in the late-line setting, your healthcare provider will perform a test to make sure that ZEJULA is right for you.
ZEJULA may cause serious side effects such as bone marrow problems called MDS or a type of blood cancer called AML, which may lead to death. Symptoms of low blood cell counts may include weakness and can be a sign of serious bone marrow problems. Contact your doctor for new onset of bleeding, fever, or infection. High blood pressure is common and can become serious. Posterior Reversible Encephalopathy Syndrome (PRES) is a condition that affects the brain and may happen during treatment with ZEJULA. Tell your doctor about all your medical conditions and medications, and if you are pregnant or breastfeeding or plan to be. Some common side effects include nausea, low blood cell counts, tiredness, constipation, muscle and back pain, headache, and trouble sleeping.
Please see additional Important Safety information below.“
My oncologist, primary care physician, and surgeon were extremely receptive to my husband’s research and thought that ZEJULA could be a good fit for me at a later point in my treatment journey and after the product was FDA approved, which occurred a short time later,” says Maryann. After completion and a response to her second round of chemotherapy, ZEJULA was added to her treatment plan, at which point it was already FDA approved. Maryann recalls, “The decision to start ZEJULA included a discussion with my oncologist about all the possible side effects and the routine monitoring of my blood counts, blood pressure, and heart rate that would be required.” Maryann and her doctor felt that it could be a good option for her. Some women may be reluctant to go on maintenance therapy after the intensity and invasiveness of chemotherapy. Maryann also felt the same way initially but is glad that she had an open dialogue with her doctor to understand all her options and find one that worked for her. She would do it again, especially now that ZEJULA is approved for use in the first-line setting. At that time, ZEJULA had been approved for use only for recurrent ovarian cancer.
Maryann also attended two patient information sessions hosted by GSK*, the makers of ZEJULA, during her treatment. She advises women to seek out sessions like these early on. “That is something I didn’t do until later in my treatment, and I wish I had much sooner,” Maryann says. “They were invaluable to hear the questions asked and to see the women sharing their stories.”
While Maryann did experience side effects such as nosebleeds, fatigue, and some nausea, she worked closely with her oncologist to manage them, which included temporarily discontinuing and adjusting her dose of ZEJULA. While these are the side effects that she experienced, Maryann stresses, “It is important to talk to your healthcare providers to understand all the possible side effects associated with ZEJULA.” After some time, Maryann and her doctor were able to find a dose that worked for her. Maryann sees her oncologist and surgeon regularly to check her labs and monitor her blood counts, blood pressure, and heart rate as part of the requirements for treatment with ZEJULA. “If I’m having any problems with potential symptoms of my ovarian cancer, she brings me in immediately. It’s a constant partnership,” Maryann says.
Moving forward
Living with the possibility of cancer recurrence is a constant balancing act, Maryann says. You want to return to your previous life, but need to stay vigilant about your health. “Make sure you're seeing your doctor regularly and having your bloodwork done routinely,” says Maryann. “And if you sense anything is amiss — for example, increased fatigue, a sudden weight gain or loss — jump on it immediately and let your doctor know.”
Today, Maryann enjoys spending time with her family, especially her grandson. Her exercise routine — daily walks and pushups three to four times a week — helps her stay active and feel stronger. “For my family, I work hard to take care of myself. I try to exercise and eat right and keep things steady,” she says. She’s looking forward to getting back to some of her interests and hopes to travel again post-pandemic. She also wants to keep spreading awareness about ovarian cancer and reach women like herself. “Talking about it helps me immensely,” she says.
“I didn’t know anything about ovarian cancer prior to my diagnosis,” she adds. But she hopes that by sharing her experience, she can help other women know they’re not alone — and they have options.
After Maryann’s diagnosis, she faced a lot of unknowns. Now, she hopes her story inspires others to become educated about their treatment options, including maintenance therapy. This is Maryann’s experience and others may be different.
By Vicki Ritterband
Making the decision to go on maintenance therapy
Sponsored by GSK
Looking ahead
Maryann has always eaten well and exercised regularly. In early 2015, she began slowly gaining weight but chalked it up to a slowing metabolism — one consequence of getting older. Her former gynecologist was not too concerned. Then, overnight, she gained five pounds and the back pain that had been bothering her for a while became severe.
So, instead of taking the trip they’d planned for that Mother’s Day weekend, Maryann and her husband rushed to the local E.R. The hospital staff was unable to further diagnose Maryann’s condition and recommended she make an appointment to be seen that Monday. Worried, she contacted a friend who was the chief nurse at a nearby academic medical center. Maryann was transferred there, where she received her diagnosis: stage III ovarian cancer. She was 58 years old and terrified.
Reflecting on her experience, Maryann says, “I knew something was not right.” She advises women to be their own advocates and speak up if they feel their concerns are being minimized. “I now realize that you're the one who knows your body best, and I wish I had pushed my former gynecologist harder for an explanation.”
Less than 24 hours after receiving her diagnosis, Maryann underwent surgery. She knew she was in good hands. “Both my surgeon and oncologist were highly recommended by my friend, and I liked them immediately,” says Maryann. “I think those first impressions are important,” she says. For her, finding the right team to support her during her treatment was key: “I think it’s important to immediately like your doctors. Do they make you feel comfortable? How do they treat you?”
Maryann soon learned how important it is to have an open dialogue with her doctors and stay educated about her treatment options. Whenever Maryann shows up with a list of questions in hand, her doctors always take the time to answer every one and are impressed by her preparation.
“I knew something was not right.”
Living with the possibility of cancer recurrence is a constant balancing act, Maryann says. You want to return to your previous life, but need to stay vigilant about your health. “Make sure you're seeing your doctor regularly and having your bloodwork done routinely,” says Maryann. “And if you sense anything is amiss — for example, increased fatigue, a sudden weight gain or loss — jump on it immediately and let your doctor know.”
Today, Maryann enjoys spending time with her family, especially her grandson. Her exercise routine — daily walks and pushups three to four times a week — helps her stay active and feel stronger. “For my family, I work hard to take care of myself. I try to exercise and eat right and keep things steady,” she says. She’s looking forward to getting back to some of her interests and hopes to travel again post-pandemic. She also wants to keep spreading awareness about ovarian cancer and reach women like herself. “Talking about it helps me immensely,” she says.
“I didn’t know anything about ovarian cancer prior to my diagnosis,” she adds. But she hopes that by sharing her experience, she can help other women know they’re not alone — and that they may have options.
Because oncology is such a dynamic field, it’s important for those impacted to keep abreast of and have conversations about advancements such as maintenance therapy. “Be prepared,” says Maryann. “If you’re not up for researching, find someone in your family who is, so you’re ready to ask your doctors the right questions.” For Maryann, that was her husband, who stepped into the role as soon as she was diagnosed.
Maryann was back to work less than two weeks after her discharge from the hospital, though she would take time off for chemotherapy at an infusion center. The center’s staff, patients and especially Maryann’s “caring” chemo nurse, became a supportive community for one another — what Maryann dubbed her “Friday Club.” “I think that was a big factor in helping me,” she says. “Having people you can lean on after a cancer diagnosis is important.” Friends and family helped Maryann stay positive, even during tough moments of her treatment.
“Every time I left my doctor's office, I left with an appointment for the next month.”
“I was working. I was planning my daughter’s wedding: dress and venue shopping and hosting two showers.”
“Life was happening. I was working. I was planning my daughter’s wedding: dress and venue shopping and hosting two showers,” says Maryann. While fatigue sometimes made things challenging, she rallied, knowing how important the event was to her daughter.
While Maryann did experience side effects such as fatigue and some nausea, she worked closely with her oncologist to manage them, which included temporarily discontinuing and adjusting her dose of ZEJULA. While these are the side effects that she experienced, women may have different experiences taking ZEJULA. Maryann stresses, “It is important to talk to your healthcare providers to understand all the possible side effects associated with ZEJULA.” After some time, Maryann and her doctor were able to find a dose that worked for her. Maryann sees her oncologist and surgeon regularly to check her labs and monitor her blood counts, blood pressure, and heart rate as part of the requirements for treatment with ZEJULA. “If I’m having any problems with potential symptoms of my ovarian cancer, she brings me in immediately. It’s a constant partnership,” Maryann says.
Maryann underwent another course of chemotherapy. It was during this period that her husband learned about ZEJULA (niraparib, 100 mg capsules) as he was researching possible maintenance treatment options for recurrent ovarian cancer. At that time, ZEJULA was undergoing FDA review. ZEJULA is an oral drug known as a PARP-inhibitor, which may work by preventing cancer cells from repairing their damaged DNA, which can cause cancer cells to die and may slow the return or progression of cancer. ZEJULA can also affect other cells and tissues in the body.
Patients like Maryann who achieve a complete or partial response to platinum-based chemotherapy may be eligible for maintenance therapy, which can potentially help delay the time before the cancer returns.² While Maryann is BRCA-positive, ZEJULA is an approved maintenance treatment option for eligible advanced ovarian cancer patients, regardless of whether a patient has the BRCA mutation or not. BRCA stands for BReast CAncer susceptibility gene and can be inherited from a parent.
"My oncologist, primary care physician, and surgeon were extremely receptive to my husband’s research and thought that ZEJULA could be a good fit for me at a later point in my treatment journey and after the product was FDA-approved, which occurred a short time later,” says Maryann. After completion and a response to her second round of chemotherapy, ZEJULA was added to her treatment plan, at which point it was already FDA-approved. Maryann recalls, “The decision to start ZEJULA included a discussion with my oncologist about all the possible side effects and the routine monitoring of my blood counts, blood pressure, and heart rate that would be required.” Maryann and her doctor felt that it could be a good option for her. Some women may be reluctant to go on maintenance therapy after the intensity and invasiveness of chemotherapy. Maryann also felt the same way initially but is glad that she had an open dialogue with her doctor to understand all her options and find one that is appropriate for her. She would do it again, especially now that ZEJULA is approved for use in the first-line maintenance setting. At that time, ZEJULA had been approved for use as a maintenance treatment option only for recurrent ovarian cancer.
Maryann also attended two patient information sessions hosted by GSK, the makers of ZEJULA, at the time during her treatment. She advises women to seek out sessions like these early on, if possible. “That is something I didn’t do until later in my treatment, and I wish I had much sooner,” Maryann says. “They were invaluable to hear the questions asked and to see the women sharing their stories.”
“They were invaluable to hear the questions asked and to see the women sharing their stories.”
Looking back:
Reflections on living with advanced ovarian cancer
4:00pm Friday’s Club
Find the right
care team
Be your own advocate
It’s important to feel heard by your doctors. Do they make you feel comfortable? How do they treat you?
Connect with a supportive group of friends who understand what you’re going through.
Having people you can lean on after a cancer diagnosis is important.
Speak up if you feel your concerns are being minimized. You're the one who knows your body best.
Dr. Appt
Monday
@ 2:30
Share symptoms and side effects wth doctor
Make sure you're seeing your doctor regularly and having routine monitoring of your blood counts, blood pressure, and heart rate, which is required with ZEJULA. If you sense anything is amiss, let your doctor know.
It’s important to talk to your healthcare providers to understand all the possible side effects associated with ZEJULA, and let them know of any you may experience.
ORDER
Bridal Shower FLOWERS
ZEJULA is a prescription medicine used for the:
• maintenance treatment of adults with advanced ovarian cancer, fallopian tube cancer, or primary peritoneal cancer. ZEJULA is used after the cancer has responded (complete or partial response) to treatment with platinum-based chemotherapy
• maintenance treatment of adults with ovarian cancer, fallopian tube cancer, or primary peritoneal cancer that comes back. ZEJULA is used after the cancer has responded (complete or partial response) to treatment with platinum-based chemotherapy
• treatment of adults with advanced ovarian cancer, fallopian tube cancer, or primary peritoneal cancer who have been treated with 3 or more prior types of chemotherapy and who have tumors with:
º a certain BRCA gene mutation, or
º gene mutation problems and who have progressed more than 6 months after their last treatment with platinum-
based chemotherapy.
º Your healthcare provider will perform a test to make sure that ZEJULA is right for you
It is not known if ZEJULA is safe and effective in children.
ZEJULA may cause serious side effects, including:
Bone marrow problems called Myelodysplastic Syndrome (MDS) or a type of blood cancer called Acute Myeloid Leukemia (AML). Some people who have ovarian cancer and who have received previous treatment with chemotherapy or certain other medicines for their cancer have developed MDS or AML during treatment with ZEJULA. MDS or AML may lead to death.
Symptoms of low blood cell counts (low red blood cells, low white blood cells, and low platelets) are common during treatment with ZEJULA. They can be a sign of serious bone marrow problems, including MDS or AML. These symptoms may include the following:
• Weakness
• Feeling tired
• Weight loss
• Frequent infections
• Fever
• Shortness of breath
• Blood in urine or stool
• Bruising or bleeding more easily
Your doctor will do blood tests to check your blood cell counts before treatment with ZEJULA. You will be tested weekly for the first month of treatment with ZEJULA, monthly for the next 11 months of treatment, and from time to time afterward.
High blood pressure is common during treatment with ZEJULA, and it can become serious. Your doctor will check your blood pressure and heart rate at least weekly for the first two months, then monthly for the first year, and as needed thereafter during your treatment with ZEJULA.
Posterior reversible encephalopathy syndrome (PRES) is a condition that affects the brain and may happen during treatment with ZEJULA. If you have headache, vision changes, confusion, or seizure, with or without high blood pressure, please contact your doctor.
Before starting to take ZEJULA, tell your doctor about all of your medical conditions, including if you:
• Have heart problems
• Have liver problems
• Have high blood pressure
• Are allergic to FD&C Yellow No. 5 (tartrazine) or aspirin. ZEJULA capsules contain tartrazine, which may cause allergic-type reactions (including bronchial asthma) in certain people, especially people who also have an allergy to aspirin
• Are pregnant or plan to become pregnant. ZEJULA may harm an unborn baby and may cause loss of pregnancy (miscarriage)
º If you are able to become pregnant, you should use effective birth control (contraception) during treatment with
ZEJULA and for 6 months after taking the last dose of ZEJULA
º If you are able to become pregnant, your doctor may perform a pregnancy test before you start treatment with
ZEJULA
º You should tell your doctor right away if you become pregnant
• Are breastfeeding or plan to breastfeed
º ZEJULA may harm your baby. You should not breastfeed your baby during treatment with ZEJULA and for 1 month
after taking the last dose of ZEJULA
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
The most common side effects of ZEJULA include the following:
If you have certain side effects, then your doctor may change your dose of ZEJULA, temporarily stop, or permanently stop treatment with ZEJULA.
These are not all the possible side effects of ZEJULA. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
Please see Prescribing Information.
©2021 GSK or licensor.
NRPOGM210107 October 2021
Produced in USA.
Indications and Important Safety Information
Indications
Important Safety Information
• Heart not beating regularly
• Nausea
• Constipation
• Vomiting
• Pain in the stomach area
• Mouth sores
• Diarrhea
• Indigestion or heartburn
• Dry mouth
• Tiredness
• Loss of appetite
• Urinary tract infection
• Changes in liver function or other blood tests
• Pain in your muscles and back
• Headache
• Dizziness
• Change in the way food tastes
• Trouble sleeping
• Anxiety
• Sore throat
• Shortness of breath
• Cough
• Rash
• Changes in the amount or color of your urine
References
¹ Lorusso D, Mancini M, Di Rocco R, Fontanelli R, Raspagliesi F. The role of secondary surgery in recurrent ovarian cancer [published online August 5, 2012]. Int J Surg Oncol. 2012;2012:613980. doi:10.1155/2012/613980.
² Data on File. GlaxoSmithKline
Share this article
Dress fitting
@ 10:00 am
Cake Tasting
on Sunday
Unfortunately, Maryann experienced a recurrence of ovarian cancer in late 2016, a couple of months after her daughter’s wedding. Her experience is not uncommon — approximately 85% of women with advanced ovarian cancer will experience a recurrence in their lifetime.¹
Maryann had no symptoms, but because she stuck to regular check-ups with her doctor, she found out her cancer had returned. She stresses that routine appointments after remission are critical for anyone with a cancer diagnosis. “Every time I left my doctor's office, I left with an appointment for the next month,” she says. When her cancer recurred, Maryann says she “was worried, of course.” But she had “complete confidence” in her oncologist.
Research treatments and ask questions
My oncologist, primary care physician, and surgeon were extremely receptive to my husband’s research and thought that ZEJULA (niraparib, 100 mg capsules) could be a good fit for me.
ZEJULA (niraparib) Indications and Select Safety Information
ZEJULA, made by the pharmaceutical company GSK, is a prescription medicine used for the maintenance treatment of adults with advanced ovarian cancer, fallopian tube cancer or primary peritoneal cancer, whose cancer has responded (complete or partial response) to treatment with platinum-based chemotherapy. ZEJULA can be used when the cancer comes back. It can also be used in the “late-line setting,” for treatment of adults with advanced ovarian cancer, fallopian tube cancer or primary peritoneal cancer who have been treated with three or more prior types of chemotherapy and who have tumors with a certain BRCA gene mutation, or gene mutation problems who have progressed more than 6 months after their last treatment with platinum-based chemotherapy. For treatment in the late-line setting, your healthcare provider will perform a test to make sure that ZEJULA is right for you.
ZEJULA may cause serious side effects such as bone marrow problems called MDS or a type of blood cancer called AML, which may lead to death. Symptoms of low blood cell counts may include weakness and can be a sign of serious bone marrow problems. Contact your doctor for new onset of bleeding, fever, or infection. High blood pressure is common and can become serious. Posterior Reversible Encephalopathy Syndrome (PRES) is a condition that affects the brain and may happen during treatment with ZEJULA. Tell your doctor about all your medications and medical conditions, including liver problems and if you are pregnant or breastfeeding or plan to be. Some common side effects include nausea, low blood cell counts, tiredness, constipation, muscle and back pain, headache, and trouble sleeping.
Please see additional Important Safety Information below.
