In your corner

Throughout your journey with advanced liver cancer, there are many people and resources available to help, including:

You have a whole cast of colorful characters behind you—each of whom has a unique role to play in your battle against advanced liver cancer. Let’s get a roll call.

Your primary treatment team may include an oncologist, a primary care physician, nurse navigator*, and a nurse.

*Not every facility offers a nurse navigator—or they may be called by a different name. Ask your doctor if you have access to a nurse navigator.

But the list doesn’t end there. Your team may also include such healthcare professionals as a radiologist, hepatologist, care coordinator, reimbursement specialist, or social worker. PHEW, that’s a whole bunch of people.

Colorectal Cancer Treatment Group

Considering adding a new member to your treatment team? It’s important to find doctors who are the right fit for you and what you’re looking to get out of treatment. If you’re interested in finding a specialist, consider using the Find a Cancer Doctor tool from the American Society of Clinical Oncology (ASCO).

It’s worth the reminder: your loved ones are there for you. This might include your family, friends, colleagues, or even your neighbors. But sometimes it can be hard to talk about your condition. Below are some helpful tips that can help you have that conversation:

  • Remember, only you can decide when it is the right time to tell your friends and family. When you do, think about how much you want to share. Different people may need different amounts of information.
  • Talk to your friends and family about how you’re feeling. It may be difficult, but it’s good to share any feelings you might have, such as anger, anxiety, or sadness. And if you’re not ready, support groups can also lend an ear.
  • Talk to your friends and family about how they’re feeling. Asking them about their thoughts can help them know they can talk openly. But if you think their feelings will overwhelm you, it’s also okay to set boundaries and guide the conversation to what you are comfortable discussing.
  • Some people might have a hard time handling the news. It could affect your relationship, but don’t take that to mean that your friend or family member doesn’t care about you. Everyone has their own way of dealing with a tough time.
  • The most important thing: find what works for you. Maybe you want to keep others involved and informed because your loved ones give you strength. Maybe that’s not the kind of relationship you and your family or friends have. Everyone’s different in his or her approach.

One way to find support is through others who have been through this as well. Liver cancer organizations are available to help connect you with other patients.

Colorectal Cancer Support Group
Colorectal Cancer Stories

Share

Your experience has power, too. Share your personal cancer experience with other people living with liver cancer through the Cancer Experience Registry.

Share Your Cancer Story

Lilly has been dedicated to helping people living with cancer for more than 50 years. If you have questions, call The Lilly Answers Center (1-800-LillyRx, or 1-800-545-5979).

Although we won't be able to replace the advice of your healthcare provider, we'll do our best to help you.

Explore Lilly PatientOne for information on savings and financial assistance.

PURPOSE AND SAFETY SUMMARY
PURPOSE AND SAFETY SUMMARY

Important Facts About CYRAMZA® (sigh-RAM-zuh). It is also known as ramucirumab.

CYRAMZA is a prescription medicine used to treat certain types of cancer. It is given by intravenous (IV) infusion. An IV infusion is when a needle is placed into your vein and a medicine is given slowly. CYRAMZA is prescribed in these ways:

  • By itself or with a chemotherapy medicine called paclitaxel to treat certain kinds of stomach cancer or cancer of the area where the stomach and esophagus (food pipe) meet that is advanced or has spread to other parts of the body. The area where the stomach and esophagus meet is often called the gastroesophageal (GE) junction. CYRAMZA is for people whose stomach cancer got worse during or after certain other types of chemotherapy.
  • With a chemotherapy medicine called docetaxel to treat non-small cell lung cancer (NSCLC) that has spread to other parts of the body and has gotten worse during or after another type of chemotherapy. People who have tumors with certain abnormal genes should not receive CYRAMZA unless they have already been treated with medicine that targets those changes and their cancer became worse during treatment.
  • With a combination of chemotherapy medicines called FOLFIRI (irinotecan, folinic acid, and fluorouracil). This is given to treat colorectal cancer (CRC) that has spread to other parts of the body and has gotten worse during or after certain other types of chemotherapy.
  • By itself to treat a type of liver cancer called hepatocellular carcinoma (HCC). CYRAMZA is for people who have levels of alpha-fetoprotein of at least 400 nanograms per milliliter (ng/mL) in their blood and have been treated with another type of chemotherapy medicine called sorafenib.

It is not known if CYRAMZA is safe and effective in children.

Warnings

CYRAMZA may cause serious side effects, including:

  • Severe bleeding, including bleeding in the stomach or bowel, has happened with CYRAMZA. This can be life threatening. If severe bleeding happens, you will have to stop receiving CYRAMZA.
  • Tears in the stomach or bowel wall may happen with CYRAMZA. This can be life threatening. If you have tears in the stomach or bowel wall, you will have to stop receiving CYRAMZA.
  • Wounds may not heal quickly or completely. If you get a wound that won’t heal during treatment, you will have to stop receiving CYRAMZA. If you are having surgery, CYRAMZA treatment should be stopped beforehand. Your doctor may put you back on CYRAMZA after your surgical wound has healed.
  • Strokes, mini-strokes, blood clots, and heart attacks have happened to people on CYRAMZA. These can be fatal. If you have one of these events, you will have to stop receiving CYRAMZA.
  • Severe high blood pressure has happened with CYRAMZA. Your doctor will take your blood pressure at least every two weeks while you are receiving CYRAMZA. Depending on your blood pressure, your doctor may adjust your treatment, or pause or permanently stop it.
  • Reactions related to infusing CYRAMZA have happened. These can be severe and life threatening. Most of these reactions happened during or after the first or second CYRAMZA infusion. In severe reactions, rapid heartbeat, low blood pressure, and severe trouble breathing may happen. Your healthcare team will give you medicine before each CYRAMZA infusion and will watch you for these side effects. If a reaction happens, CYRAMZA treatment may be infused at a slower rate or may be permanently stopped, depending on how severe the reaction is.
  • CYRAMZA may worsen certain types of liver disease.
  • A very rare but serious brain disorder has been found in research trials with CYRAMZA. The disorder is called RPLS (reversible posterior leukoencephalopathy syndrome). Signs of RPLS may include headache, seizures, and changes in your vision or thinking. These symptoms usually stop or improve within days. However, the changes in thinking can be ongoing, and RPLS can be fatal.
  • Too much protein in the urine (called proteinuria) has been found in research trials with CYRAMZA. This may be a sign of kidney damage. Your doctor will watch your urine protein levels during treatment. If you develop protein in your urine, your doctor may pause your treatment and lower your dose of CYRAMZA. If you have severe proteinuria, you will have to stop receiving CYRAMZA permanently.
  • Thyroid gland problems have been found in research trials with CYRAMZA. Your doctor will do blood tests to track how well your thyroid gland works during treatment.
  • CYRAMZA can harm your unborn baby. You should avoid getting pregnant, and use effective birth control while receiving CYRAMZA and for 3 months after your last dose.
  • CYRAMZA may harm a breastfeeding child. Do not breastfeed your child during treatment with CYRAMZA and for 2 months after your last dose.

Tell your doctor right away if you have:

  • Bleeding or symptoms of bleeding, including lightheadedness.
  • Severe diarrhea, vomiting, or severe abdominal pain.
  • A wound that doesn’t heal properly or have a surgery planned.
  • High blood pressure or symptoms of high blood pressure, including severe headache or lightheadedness or confusion, changes in your vision, or seizure.
  • Symptoms of infusion reactions, including:
    • Shaking or stiffness of the body
    • Back pain or spasms
    • Chest pain or tightness
    • Chills
    • Flushing (sudden warmth and/or reddened skin on the face, neck, or upper chest)
    • Difficulty breathing
    • Wheezing (a whistling sound in the breath caused by narrowed breathing tubes)
    • Becoming blue due to lack of oxygen
    • Tingling or numbness of the skin
  • Had liver disease or other liver problems.
Common side effects

The most common side effects of CYRAMZA when given by itself include:

  • Low blood platelet count
  • Feeling tired
  • Low albumin (protein in the blood)
  • Low sodium in the blood
  • Swelling in the arms, legs, hands, or feet
  • High blood pressure
  • Stomach pain
  • Low white blood cell count
  • Not feeling hungry
  • Too much protein in the urine
  • Feeling like you want to throw up (vomit)
  • Unusual buildup of fluid in the belly
  • Low calcium in the blood
  • Headache
  • Diarrhea
  • Nose bleeds
  • Trouble falling or staying asleep
  • Fever
  • Vomiting
  • Back Pain

The most common serious side effects of CYRAMZA when given by itself include:

  • Anemia (a decrease in red blood cells)
  • Blocked digestive tract
  • Unusual buildup of fluid in the belly
  • Pneumonia

Some people needed to have extra red blood cells put into their blood.

The most common side effects of CYRAMZA when given with certain chemotherapy medicines include:

  • Low white blood cell count
  • Diarrhea
  • Tiredness
  • Mouth sores with or without swelling in the lining of the mouth
  • Decreased appetite
  • Nose bleeds
  • Low blood platelet count
  • High blood pressure
  • Swelling in the arms, legs, hands, or feet
  • Too much protein in the urine
  • Low white blood cell count with fever
  • Swelling, redness, or pain in the palms or soles (hand-foot syndrome)
  • Increased production of tears
  • Bleeding in the digestive tract
  • Low albumin (a protein in the blood)

The most common serious side effects of CYRAMZA when given with certain chemotherapy medicines include:

  • Low white blood cell count with fever
  • Pneumonia
  • Low white blood cell count
  • Diarrhea
  • Blocked digestive tract

Some people needed treatment to increase their white blood cell counts.

These are not all the possible side effects of CYRAMZA. Tell your doctor if you have any side effects. You can report side effects at 1-800-FDA-1088 or www.fda.gov/medwatch.

Before using

Before you receive CYRAMZA, tell your doctor if you:

  • Have had or are at high risk for strokes or heart attack.
  • Have high blood pressure or have blood pressure problems.
  • Are planning to have surgery of any kind.
  • Have ever had liver problems, including cirrhosis or other diseases of the liver.
  • Are pregnant or may be pregnant: CYRAMZA can harm your unborn baby. You should avoid getting pregnant and use effective birth control during treatment with CYRAMZA and for 3 months after the last dose.
  • Are breastfeeding: Your doctor will tell you to stop breastfeeding during treatment with CYRAMZA and for 2 months after the last dose.

Also tell your doctor about all the medicines and supplements you take, whether they have been prescribed for you or you buy them without a prescription.

How to take
  • CYRAMZA is given by intravenous (IV) infusion. The infusion will last 60 minutes. If you handle the first infusion of CYRAMZA well, then your next CYRAMZA infusions may only take 30 minutes. The schedule for receiving CYRAMZA depends on what type of cancer you are being treated for. These are typical schedules:
    • Once every 2 weeks for stomach cancer or GE junction cancer that is advanced or has spread to other parts of the body, colorectal cancer that has spread to other parts of the body, or hepatocellular carcinoma that has AFP levels of at least 400 ng/mL or higher.
    • Once every 3 weeks for non-small cell lung cancer that has spread to other parts of the body.
  • Your doctor will give you other medicines before your CYRAMZA infusion to help lower the chance of an infusion reaction.
Learn more

For more information, call 1-800-545-5979 or go to CYRAMZA.com.

This summary provides basic information about CYRAMZA. It does not include everything known about this medicine. This information does not take the place of talking with your doctor. Be sure to talk to your doctor or other healthcare provider about CYRAMZA and how it is given. Your doctor is the best person to help you decide if CYRAMZA is right for you.

Please click for Full Prescribing Information for Cyramza.

CYRAMZA® is a registered trademark owned or licensed by Eli Lilly & Company, its subsidiaries, or affiliates.

RB CON BS 08AUG2019