When living with metastatic colorectal cancer (mCRC)...

CYRAMZA can help keep you fighting for what matters to you


You're not the type who settles. You're the type who pushes for more. But where individual results with CYRAMZA can vary, clinical studies have shown

CYRAMZA Efficacy

CYRAMZA may help you live longer

56% of people lived 1 year or longer with CYRAMZA + FOLFIRI (a type of chemotherapy) vs 48% with chemotherapy alone

  • Half of the people who received CYRAMZA + chemotherapy after their cancer progressed were still alive at 13.3 months vs 11.7 months with chemotherapy alone
Treatment of CYRAMZA + Chemotherapy

CYRAMZA provided more time without disease progression

47% of people had delayed disease progression for 6 months or longer with CYRAMZA + chemotherapy vs 36% with chemotherapy alone

  • Half of the people who received CYRAMZA + chemotherapy lived without their cancer getting worse for 5.7 months vs 4.5 months with chemotherapy alone

CYRAMZA was studied in a clinical trial of 1072 people with metastatic colorectal cancer who received CYRAMZA + FOLFIRI (536 people) vs those who received FOLFIRI alone (536 people). All people in the study had previously received bevacizumab, oxaliplatin, and a fluoropyrimidine (other types of chemotherapy).

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What to expect during treatment

You’ve decided to move forward and are ready to start treatment. Let’s do this.

CYRAMZA infusion

Treatment will be given by an intravenous (IV) infusion, in either the doctor's office, a hospital, or an infusion center.

60-minute administration

First, you’ll be given CYRAMZA (60 minute infusion), followed by your chemotherapy (60 minute infusion).

Before you receive CYRAMZA, your doctor will give you different medicines to help prevent an allergic reaction that may occur during the infusion.

CYRAMZA with or without chemo

CYRAMZA combines with FOLFIRI (a type of chemotherapy) to help fight your cancer.

Understanding your dosing schedule with CYRAMZA

CYRAMZA 14-day Cycle Dosing Schedule

CYRAMZA + FOLFIRI (A TYPE OF CHEMOTHERAPY)

CYRAMZA + FOLFIRI will be given to you once every 2 weeks, or as recommended by your doctor.

Your doctor will determine the number of treatments you receive.

Preparing for treatment

SELECT IMPORTANT SAFETY INFORMATION

Infusion reactions related to injecting CYRAMZA have occurred. Most of these reactions happened during or after the first or second CYRAMZA infusion. Signs and symptoms of infusion reactions include shaking or stiffness of the body, back pain or spasms, chest pain or tightness, chills, flushing, difficulty breathing, wheezing, becoming blue due to lack of oxygen, and tingling or numbness of the skin. In severe cases, rapid heartbeat, low blood pressure, and severe trouble breathing may occur. Your healthcare team will monitor you for these side effects. In the case of a severe infusion reaction, your CYRAMZA treatment will have to be immediately and permanently stopped.

Tips for day of treatment and beyond

You may be nervous about your first treatment. Or maybe you're an old pro at this. But no matter where you're coming from, here are some important tips to help get you through each infusion with CYRAMZA:

Get prepared: Get a good night’s sleep, hydrate, and eat a healthy, light meal at least 2 hours before treatment. Make sure to ask your healthcare provider for their advice.

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Dress down: Everyone has their go-to outfit that makes them feel snug and safe. Whether it’s a sweater and leggings or an old hoodie, designate your comfy outfit ahead of time so you can just grab and go.

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Buddy up: Ask a friend or loved one to accompany you to your appointment for support. You’ll need a ride home from treatment, so they can also serve as your driver—and entertainment, too.

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Pack a toolkit: Speaking of entertainment, pack a bag with plenty of distractions: books, magazines, music, games, entertainment on your laptop, tablet, or phone. While you’re distracted, it’s also important to keep comfy—a travel-size pillow and extra sweater or blanket can help you stay both cozy and warm. Don’t forget to also bring beverages, light snacks, and candy or mints. This can help you stay hydrated, keep your energy up, and combat any dry mouth or nausea that treatment might cause. Make sure to ask your doctor if it's okay to bring these items with you. Treatment may also cause cracked lips, so consider packing lip balm in your bag as well.

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Take a minute: First things first, take a deep breath and congratulate yourself for another round down.

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Take ten: How are you feeling? What went well? What would you change for next time? Consider keeping a journal with your notes, and if you’re experiencing any side effects, make sure to mention these to your doctor.

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Take a load off: If you’re up for it, make time to see your family and friends. Loved ones are a great way to restore strength.

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Eating healthy and living well

When living with colorectal cancer, good nutrition is essential. Talk to your doctor about strategies that can help keep you eating healthy. He or she might recommend eating six small meals a day to help you maintain weight and balance your blood sugar. Your doctor might also mention incorporating more high-protein foods, like:

Fish

Fish

Lean meats

Lean meats

Cooked Vegetables

Cooked Vegetables

Smoothies

Smoothies

However, maintaining a nutritious diet can be difficult if you’re too tired to eat or having trouble keeping anything down. You may be experiencing side effects from treatment, like nausea or mouth sores, that also may cause you to lose your appetite.

You may be feeling frustrated. It can be hard to retrain your body to eat in this new way. And if you’ve had a colostomy, there may be some foods that you might need to limit—and some that might be helpful—in order to better manage your colostomy bag. Food you might need to limit include raw vegetables, fruit skins and peels, dairy products, high-fiber food, beans, peas, lentils, brown and wild rice, nuts and seeds, sweets, and high-fat and fried foods. Foods that can be helpful include cranberry juice, bananas, apple sauce, well-cooked sticky white rice, buttermilk, tapioca, and white toast. It’s important to listen to your body and communicate any changes in bowel habits (including diarrhea, constipation, bloating, and gas) to your healthcare team.

In addition to eating right, it’s important to keep balance in your life. Reducing stress can help you feel energized, so you can focus on the things that matter most. Stress-reducing activities include:

Exercise

Exercise

Resting

Resting

Yoga or meditation

Yoga or meditation

Understanding common side effects

CYRAMZA in combination with FOLFIRI (a type of chemotherapy) may cause side effects. If you experience new symptoms while on treatment, it is important that you speak with your doctor.

Explore the most common side effects of CYRAMZA, below.

CYRAMZA + chemotherapy

The most common side effects were:

Diarrhea; low white blood cell count; decreased appetite; nosebleeds; mouth sores; low platelet count; high blood pressure; swelling in the arms, legs, hands, and or feet; too much protein in the urine; hand-foot syndrome; bleeding in the gastrointestinal tract; low albumin (a protein in the blood)

The most common serious side effects were:

Diarrhea, blockage of the intestine, and low white blood cell count with fever

Please see Important Safety Information, including boxed Warning for severe bleeding, tears in stomach or bowel wall, and difficulty in wound healing, below, and full Prescribing Information for complete safety information for CYRAMZA.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/safety/medwatch or call 1-800-FDA-1088.

Talk to your doctor about any questions, concerns, or side effects you might have with CYRAMZA. Your doctor may be able to make recommendations to help you feel more comfortable.

In your corner

Throughout your journey with metastatic colorectal cancer (CRC), 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 metastatic CRC. 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, gastroenterologist, dietitian or nutritionist 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, use 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. Anyone whose life you’ve touched is in this right alongside you. 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. Colorectal 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 colorectal 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.

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INDICATIONS and IMPORTANT SAFETY INFORMATION Warning: Severe bleeding, tears in the stomach or bowel wall, and difficulty in wound healing
Warning: Severe bleeding, tears in the stomach or bowel wall, and difficulty in wound healing
Indication
  • CYRAMZA is used with a chemotherapy combination called FOLFIRI (irinotecan, folinic acid, and 5-fluorouracil) to treat metastatic colorectal cancer (mCRC) in patients whose cancer has progressed on or after being treated with other certain types of chemotherapy.
What is the most important information I should know about CYRAMZA?

WARNING: SEVERE BLEEDING, TEARS IN THE STOMACH OR BOWEL WALL, AND DIFFICULTY IN WOUND HEALING

Severe bleeding, including bleeding in the stomach or bowel, has occurred with CYRAMZA. These events are sometimes fatal. Tell your doctor right away if you have bleeding or symptoms of bleeding, including lightheadedness. Your treatment will have to be permanently stopped if severe bleeding occurs.

Tears in the stomach or bowel wall may occur with CYRAMZA. These events are sometimes fatal. Tell your doctor if you have severe diarrhea, vomiting, or severe abdominal pain. Your treatment will have to be permanently stopped if this occurs.

Wounds may have difficulty healing with drugs like CYRAMZA. Tell your doctor if you have a wound that doesn’t heal properly. If you develop a wound that won’t heal during treatment, your doctor will stop CYRAMZA until the wound is fully healed. Also tell your doctor if you have planned surgery, as CYRAMZA treatment should be interrupted prior to surgery. Your doctor may restart CYRAMZA after your surgical wound has healed.

Possible Serious Side Effects
  • Strokes, mini-strokes, blood clots, and heart attacks have occurred in clinical trials with CYRAMZA. These events are sometimes fatal. Your treatment will have to be permanently stopped if these events occur.
  • Severe high blood pressure has occurred with CYRAMZA treatment. Your doctor will monitor your blood pressure every two weeks or more throughout treatment and may adjust, interrupt, or permanently stop treatment depending on the results. Tell your doctor if your blood pressure is high or if you have symptoms of high blood pressure, including severe headache or lightheadedness, or neurologic symptoms such as confusion, changes in your vision, or seizure.
  • Infusion reactions related to injecting CYRAMZA have occurred. Most of these reactions happened during or after the first or second CYRAMZA infusion. Signs and symptoms of infusion reactions include shaking or stiffness of the body, back pain or spasms, chest pain or tightness, chills, flushing, difficulty breathing, wheezing, becoming blue due to lack of oxygen, and tingling or numbness of the skin. In severe cases, rapid heartbeat, low blood pressure, and severe trouble breathing may occur. Your healthcare team will monitor you for these side effects. In the case of a severe infusion reaction, your CYRAMZA treatment will have to be immediately and permanently stopped.
  • CYRAMZA may worsen certain types of liver disease. Tell your doctor if you have or have had liver disease or other liver problems.
  • RPLS (reversible posterior leukoencephalopathy syndrome), a very rare but serious brain disorder, has been reported in clinical trials with CYRAMZA. Signs and symptoms of RPLS may include headache, seizures, visual changes, and changes in mental function. These symptoms usually stop or improve within days, but some patients can experience continuing changes in mental function or death.
  • Too much protein in the urine (proteinuria) has been reported in clinical trials with CYRAMZA. This may be a sign of kidney damage. Your doctor will monitor your urine protein levels during treatment. If you develop protein in your urine, your doctor may interrupt your treatment and decrease your dose of CYRAMZA. In severe cases your treatment will have to be permanently stopped.
  • Thyroid gland problems have been reported in clinical trials with CYRAMZA. Your doctor will do blood tests to monitor your thyroid gland function during treatment.
  • CYRAMZA can harm your unborn baby. You should avoid getting pregnant, and use adequate contraception while receiving CYRAMZA and for at least 3 months after stopping CYRAMZA.
What are the most common side effects of CYRAMZA?
  • The most common side effects reported in patients treated with CYRAMZA when given in combination with FOLFIRI (irinotecan, folinic acid, and 5-fluorouracil) were diarrhea; low white blood cell count; decreased appetite; nosebleeds; mouth sores; low platelet count; high blood pressure; swelling in the arms, legs, hands, or feet; too much protein in the urine; hand-foot syndrome; bleeding in the gastrointestinal tract; and low albumin (a protein in the blood). The most common serious adverse events with CYRAMZA plus FOLFIRI were diarrhea, blockage of the intestine, and low white blood cell count with fever. Treatment to increase white blood cell count called granulocyte colony-stimulating factors was given to 20% of patients treated with CYRAMZA plus FOLFIRI.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/safety/medwatch or call 1-800-FDA-1088.

What should I tell my doctor before receiving treatment with CYRAMZA?

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 or have had liver problems, including liver 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 adequate contraception while receiving CYRAMZA and for at least 3 months after stopping CYRAMZA.
  • Are breastfeeding: your doctor will tell you to stop breastfeeding during treatment.

Tell your doctor about all the medications you are taking, including prescription and over-the-counter medications.

How is CYRAMZA given?
  • CYRAMZA is slowly infused (injected) into your vein. The infusion will last about 60 minutes. You will usually receive CYRAMZA once every 2 weeks prior to FOLFIRI.
  • Your doctor will also give additional medication(s) prior to your CYRAMZA infusion to address potential side effects.

CYRAMZA is available by prescription only.

Please see full Prescribing Information for additional information about CYRAMZA, including Boxed Warning for severe bleeding, tears in the stomach or bowel wall, and difficulty in wound healing. RB-C CON ISI 18DEC2017