Indications
Atezolizumab is an immunotherapy medicine used to treat certain cancers, including some types of non-small cell lung cancer, extensive-stage small cell lung cancer, liver cancer (hepatocellular carcinoma), urothelial (bladder) cancer, melanoma and some other cancers, depending on the tumour type and test results. It may be given alone or with chemotherapy or other cancer medicines. A cancer specialist decides whether it is suitable.
How It Works
Atezolizumab is a monoclonal antibody, a laboratory-made protein that attaches to a target called PD-L1. Many cancer cells use PD-L1 to switch off T cells, the immune cells that attack tumours. By blocking PD-L1, Atezolizumab releases this brake so the immune system can recognise and attack cancer cells again.
Dosage and Administration
Atezolizumab is given as an infusion into a vein (or, for some products, as an injection under the skin) by a doctor or nurse in a hospital or cancer clinic, usually every 2, 3 or 4 weeks. The dose and length of treatment are as prescribed by the oncologist and depend on the cancer type, other treatments and how well it is tolerated. Blood tests are done before and during treatment.
Interactions
No major drug interactions through the liver are expected. However, steroids or other medicines that suppress the immune system taken before starting treatment may reduce its effect, so tell your doctor about them. Steroids are often used later to treat immune side effects, which is acceptable. Tell your doctor about all medicines, herbal products and vaccines.
Contraindications
Do not use if you have had a severe allergic reaction to Atezolizumab or any ingredient of the product. Extra care is needed in people with active autoimmune disease, organ transplants or serious liver disease.
Side Effects
Common side effects include tiredness, loss of appetite, nausea, cough, shortness of breath, fever, rash, itching, joint or muscle pain, diarrhoea and infusion reactions (chills, fever or flushing during the drip). Because it activates the immune system, it can cause inflammation in any organ, such as the lungs (pneumonitis), bowel (colitis), liver (hepatitis), hormone glands (thyroid, adrenal, pituitary, pancreas leading to diabetes), kidneys, skin, nerves or heart. These can appear during or even months after treatment.
Get urgent medical help if you have new or worse cough, chest pain or breathlessness, severe or bloody diarrhoea, severe stomach pain, yellow skin or eyes, extreme tiredness, confusion, severe headache, very high thirst or urination, blistering rash, muscle weakness, or a high fever.
Pregnancy and Lactation
Atezolizumab may harm an unborn baby. Women who could become pregnant should use effective contraception during treatment and for at least 5 months after the last dose. Do not breastfeed during treatment and for at least 5 months after the last dose.
Precautions and Warnings
- Carry a card or note saying you are on immunotherapy and show it to any doctor you see.
- Report new symptoms early; immune side effects are easier to treat when caught early.
- Thyroid, liver and kidney function and blood sugar are checked regularly.
- Tell your doctor if you have an autoimmune disease, a transplant, or are on immune-suppressing medicine.
Overdose
Because it is given in hospital, overdose is unlikely. If it happens, the patient is watched closely for side effects and treated as needed. There is no specific antidote.
Therapeutic Class
Anticancer immunotherapy; PD-L1 blocking monoclonal antibody (immune checkpoint inhibitor).
Storage
Store in a refrigerator at 2 to 8°C, do not freeze, and keep the vial in the outer carton to protect from light. It is stored and prepared by hospital staff as directed on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.