Atezolizumab

Atezolizumab Brand Name– Tecentriq

What is Atezolizumab

Atezolizumab is an Fc-engineered, humanized, non-glycosylated IgG1 kappa monoclonal antibody that binds to and blocks programmed death-ligand 1 (PD-L1).

It is indicated for certain types of urothelial carcinoma, non-small cell lung cancer, small cell lung cancer, and triple-negative breast cancer.

Treatment with atezolizumab may result in severe immune-related adverse reactions requiring interruption or discontinuation of therapy, as well as treatment with high-dose corticosteroids.

Infusion-related reactions may also occur.

Indications

  1. bladder cancer
  2. breast cancer
  3. non-small cell lung cancer (NSCLC)
  4. renal cell cancer
  5. small cell lung cancer (SCLC)
  6. urothelial carcinoma

For the treatment of urothelial carcinoma, including bladder cancer and other urinary system cancers

for the treatment of locally advanced or metastatic urothelial carcinoma, including bladder cancer and other urinary system cancers, in patients who progress during or following any platinum-containing chemotherapy

Side Effects

  1. abdominal pain
  2. abdominal pain
  3. acneiform rash
  4. adrenocortical insufficiency
  5. adrenocortical insufficiency
  6. alopecia
  7. anemia
  8. anemia
  9. anorexia
  10. anorexia
  11. antibody formation
  12. arthralgia
  13. arthralgia
  14. asthenia
  15. asthenia
  16. back pain
  17. back pain
  18. bone pain
  19. bowel ischemia
  20. bullous rash
  21. colitis
  22. colitis
  23. confusion
  24. constipation
  25. constipation
  26. cough
  27. cough
  28. cystitis
  29. dehydration
  30. diabetes mellitus
  31. diabetic ketoacidosis
  32. diarrhea
  33. diarrhea
  34. dizziness
  35. dysesthesia
  36. dysgeusia
  37. dyspnea
  38. dyspnea
  39. edema
  40. elevated hepatic enzymes
  41. elevated hepatic enzymes
  42. encephalopathy
  43. enterocolitis
  44. epistaxis
  45. erythema multiforme
  46. fatigue
  47. fatigue
  48. fever
  49. fever
  50. GI obstruction
  51. Guillain-Barre syndrome
  52. headache
  53. hematuria
  54. hematuria
  55. hemolytic anemia
  56. hemoptysis
  57. hepatitis
  58. hepatitis
  59. hyperamylasemia
  60. hyperbilirubinemia
  61. hyperglycemia
  62. hyperkalemia
  63. hypermagnesemia
  64. hypermagnesemia
  65. hyperphosphatemia
  66. hypertension
  67. hyperthyroidism
  68. hypoalbuminemia
  69. hypoalbuminemia
  70. hypocalcemia
  71. hypoesthesia
  72. hypokalemia
  73. hypomagnesemia
  74. hyponatremia
  75. hyponatremia
  76. hypophosphatemia
  77. hypophosphatemia
  78. hypophysitis
  79. hypothyroidism
  80. infection
  81. infection
  82. infusion-related reactions
  83. infusion-related reactions
  84. intracranial bleeding
  85. iritis
  86. lethargy
  87. lethargy
  88. leukopenia
  89. lymphopenia
  90. lymphopenia
  91. maculopapular rash
  92. malaise
  93. malaise
  94. meningitis
  95. musculoskeletal pain
  96. myalgia
  97. myalgia
  98. myasthenia
  99. myocarditis
  100. nausea
  101. nausea
  102. nephrotic syndrome
  103. neutropenia
  104. pancreatitis
  105. paresis
  106. paresthesias
  107. peripheral edema
  108. peripheral edema
  109. peripheral neuropathy
  110. pharyngitis
  111. pleural effusion
  112. pneumonitis
  113. pneumonitis
  114. proteinuria
  115. pruritus
  116. pruritus
  117. psoriaform rash
  118. pulmonary embolism
  119. purpura
  120. rash
  121. rash
  122. renal failure (unspecified)
  123. rhabdomyolysis
  124. Stevens-Johnson syndrome
  125. stroke
  126. thrombocytopenia
  127. thromboembolism
  128. toxic epidermal necrolysis
  129. uveitis
  130. vasculitis
  131. Vogt-Koyanagi-Harada syndrome
  132. vomiting
  133. vomiting

Monitoring Parameters

  • blood glucose
  • LFTs
  • pregnancy testing
  • thyroid function tests (TFTs)

Contraindications

  • adrenal insufficiency
  • autoimmune disease
  • breast-feeding
  • colitis
  • contraception requirements
  • diabetes mellitus
  • diabetic ketoacidosis
  • diarrhea
  • hepatic disease
  • hepatitis
  • hyperthyroidism
  • hypophysitis
  • hypopituitarism
  • hypothyroidism
  • immune-mediated reactions
  • infection
  • infertility
  • infusion-related reactions
  • myocarditis
  • pancreatitis
  • pneumonitis
  • pregnancy
  • pregnancy testing
  • pulmonary disease
  • renal impairment
  • reproductive risk
  • thyroid disease
  • uveitis

Interactions

  • Palifermin
  • Penicillamine
  • Tuberculin Purified Protein Derivative, PPD

Palifermin: (Moderate) Palifermin should not be administered within 24 hours before, during infusion of, or within 24 hours after administration of antineoplastic agents. 

Penicillamine: (Major) Do not use penicillamine with antineoplastic agents due to the increased risk of developing severe hematologic and renal toxicity. 

Tuberculin Purified Protein Derivative, PPD: (Moderate) Immunosuppressives may decrease the immunological response to tuberculin purified protein derivative, PPD. This suppressed reactivity can persist for up to 6 weeks after treatment discontinuation. Consider deferring the skin test until completion of the immunosuppressive therapy.

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