Tecentriq® (atezolizumab) is an immunotherapy medication that may be used for the treatment of certain forms of non-small cell lung cancer (NSCLC). It can be used as an initial treatment option for metastatic (has spread to other parts of the body) NSCLC in those with tumors showing high PD-L1 expression, that do not have EGFR or ALK gene abnormalities.6 Atezolizumab is the first approved anti-PD-L1 immunotherapy. Additionally, atezolizumab may be used for the treatment of metastatic NSCLC in people whose cancer has gotten worse after receiving platinum based chemotherapy. Within this category, patients with NSCLC that have EGFR or ALK gene abnormalities should have also tried treatment with approved therapy for these abnormalities, that stopped working, before receiving treatment with atezolizumab. Atezolizumab may also be used for metastatic non-squamous NSCLC that does not have EGFR or ALK gene abnormalities, together with certain chemotherapy combinations as first-line treatment.4
In addition, atezolizumab is approved for extensive-stage small cell lung cancer (SCLC) as first line-treatment in combination with certain chemotherapy medications.1,5
The role of the PD-1 receptor
Researchers have identified several pathways where cancer cells suppress the T-cell immune response. One of the pathways that is affected in some people with NSCLC is the PD-1 receptor and the proteins which bind to the receptor, PD-L1 and PD-L2. When this pathway is affected by the cancer cells, the cancer can grow and spread without being kept in check by T-cells. Atezolizumab targets the PD-L1 pathway. By blocking this pathway, atezolizumab may help the body’s own immune system to fight the cancer.1,2
Atezolizumab is given as an infusion that is administered through an IV (intravenous) line. The schedule and dosage will be determined by the patient’s doctor.2
Side effects of atezolizumab
Atezolizumab may cause side effects, and in some cases, these side effects can be serious. Any side effects should be reported to a health care professional. The most common side effects experienced by patients receiving atezolizumab together with other therapies for lung cancer include fatigue, decreased appetite, nausea, diarrhea, hair loss, and constipation.1
Possible serious side effects with atezolizumab include lung problems (such as pneumonitis), liver problems (such as hepatitis), intestinal problems (such as colitis), hormone gland problems (especially the pituitary, thyroid, adrenal glands and pancreas), nervous system problems (such as neuropathy, meningitis and encephalitis), eye problems (such as inflammation), severe infections (such as sepsis and encephalitis), and severe infusion reactions.1,3
This is not an exhaustive list of all potential side effects of atezolizumab. Talk to your healthcare provider or pharmacist for further information.
Patients receiving atezolizumab should talk to their doctor about any other medications (prescription and over-the-counter), herbal remedies, and any supplements they are taking, as well as any other health conditions.
Patients who are pregnant or may become pregnant during treatment should discuss their condition with their doctor prior to starting atezolizumab, as it may be hazardous to the fetus. It is not recommended for women to conceive a child while taking atezolizumab, and patients are advised to use contraception during treatment and for at least five months after the final dose of atezolizumab (patients should discuss appropriate birth control methods with their doctor). It is not known whether atezolizumab passes into breast milk, and patients should not breastfeed while taking atezolizumab and for at least five months after the final dose of atezolizumab. Patients should talk to their doctor if they have any questions, or if they have questions regarding their atezolizumab regimen.3