Tecentriq

Generic name: atezolizumab
Drug class: Anti-PD-1 monoclonal antibodies

Medically reviewed by  A Ras MD.

What is Tecentriq?

Tecentriq is a prescription medicine used to treat adults with the following conditions:

• a type of bladder and urinary tract cancer called urothelial carcinoma. Tecentriq may be used when your bladder cancer has spread or cannot be removed by surgery, and if you have any one of the following conditions:
  • you are not able to take chemotherapy that contains a medicine called cisplatin, and your cancer tests positive for “PD-L1”, or
  • you are not able to take chemotherapy that contains any platinum regardless of “PD-L1” status, or
  • you have tried chemotherapy that contains platinum, and it did not work or is no longer working.
• a type of lung cancer called non-small cell lung cancer (NSCLC).
  • Tecentriq may be used alone as your first treatment when your lung cancer:
    • has spread or grown, and
    • your cancer tests positive for “high PD-L1”, and
    • your tumor does not have an abnormal “EGFR” or “ALK” gene.
  • Tecentriq may be used with the medicines bevacizumab, paclitaxel, and carboplatin as your first treatment when your lung cancer:
    • has spread or grown, and
    • is a type called “non-squamous NSCLC”, and
    • your tumor does not have an abnormal “EGFR” or “ALK” gene.
  • Tecentriq may be used with the medicines paclitaxel protein-bound and carboplatin as your first treatment when your lung cancer:
    • has spread or grown, and
    • is a type called “non-squamous NSCLC”, and
    • your tumor does not have an abnormal “EGFR” or “ALK” gene.
  • Tecentriq may also be used alone when your lung cancer:
    • has spread or grown, and
    • you have tried chemotherapy that contains platinum, and it did not work or is no longer working.
    • if your tumor has an abnormal “EGFR” or “ALK” gene, you should have also tried an FDA-approved therapy for tumors with these abnormal genes, and it did not work or is no longer working.
• a type of breast cancer called triple-negative breast cancer (TNBC). Tecentriq may be used with the medicine paclitaxel protein-bound when your breast cancer:
  • has spread or cannot be removed by surgery, and
  • your cancer tests positive for “PD-L1”.
• a type of lung cancer called small cell lung cancer (SCLC). Tecentriq may be used with the chemotherapy medicines carboplatin and etoposide as your first treatment when your lung cancer
  • is a type called “extensive-stage SCLC,” which means that it has spread or grown
• a type of liver cancer called hepatocellular carcinoma (HCC). Tecentriq may be used with the medicine bevacizumab when your liver cancer:
  • has spread or cannot be removed by surgery, and
  • you have not received other medicines by mouth or injection through your vein (IV) to treat your cancer.
• a type of skin cancer called melanoma. Tecentriq may be used with the medicines cobimetinib and vemurafenib when your melanoma:
  • has spread to other parts of the body or cannot be removed by surgery, and
  • has a certain type of abnormal “BRAF” gene. Your healthcare provider will perform a test to make sure this Tecentriq combination is right for you.

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

Description

Atezolizumab is a programmed cell death ligand 1 (PD-L1) blocking antibody. Atezolizumab is an Fc-engineered, humanized, non-glycosylated IgG1 kappa immunoglobulin that has a calculated molecular mass of 145 kDa.

TECENTRIQ (atezolizumab) injection for intravenous use is a sterile, preservative-free, colorless to slightly yellow solution in single-dose vials. Each 20 mL vial contains 1200 mg of atezolizumab and is formulated in glacial acetic acid (16.5 mg), L-histidine (62 mg), polysorbate 20 (8 mg), and sucrose (821.6 mg), with a pH of 5.8. Each 14 mL vial contains 840 mg of atezolizumab and is formulated in glacial acetic acid (11.5 mg), L-histidine (43.4 mg), polysorbate 20 (5.6 mg), and sucrose (575.1 mg) with a pH of 5.8.

Mechanism of Action

PD-L1 may be expressed on tumor cells and/or tumor infiltrating immune cells and can contribute to the inhibition of the anti-tumor immune response in the tumor microenvironment. Binding of PD-L1 to the PD-1 and B7.1 receptors found on T cells and antigen presenting cells suppresses cytotoxic T-cell activity, T-cell proliferation and cytokine production.

Atezolizumab is a monoclonal antibody that binds to PD–L1 and blocks its interactions with both PD-1 and B7.1 receptors. This releases the PD-L1/PD-1 mediated inhibition of the immune response, including activation of the anti-tumor immune response without inducing antibody-dependent cellular cytotoxicity. In syngeneic mouse tumor models, blocking PD–L1 activity resulted in decreased tumor growth.

In mouse models of cancer, dual inhibition of the PD-1/PD-L1 and MAPK pathways suppresses tumor growth and improves tumor immunogenicity through increased antigen presentation and T cell infiltration and activation compared to targeted therapy alone.

What is the most important information I should know about Tecentriq?

Tecentriq is a medicine that may treat certain cancers by working with your immune system. Tecentriq can cause your immune system to attack normal organs and tissues and can affect the way they work. These problems can sometimes become serious or life-threatening and can lead to death.

Call or see your healthcare provider right away if you get any symptoms of the following problems or these symptoms get worse:

• Lung problems (pneumonitis). Signs and symptoms of pneumonitis may include:
  • new or worsening cough
  • shortness of breath
  • chest pain
• Liver problems (hepatitis). Signs and symptoms of hepatitis may include:
  • yellowing of your skin or the whites of your eyes
  • severe nausea or vomiting
  • pain on the right side of your stomach area (abdomen)
  • drowsiness
  • dark urine (tea colored)
  • bleeding or bruising more easily than normal
  • feeling less hungry than usual
• Intestinal problems (colitis). Signs and symptoms of colitis may include:
  • diarrhea (loose stools) or more bowel movements than usual
  • blood or mucus in your stools or dark, tarry, sticky stools
  • severe stomach area (abdomen) pain or tenderness
• Hormone gland problems (especially the thyroid, adrenal glands, pancreas, and pituitary). Signs and symptoms that your hormone glands are not working properly may include:
  • headaches that will not go away or unusual headaches
  • extreme tiredness
  • weight gain or weight loss
  • dizziness or fainting
  • feeling more hungry or thirsty than usual
  • hair loss
  • changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness
  • feeling cold
  • constipation
  • your voice gets deeper
  • urinating more often than usual
  • nausea or vomiting
  • stomach area (abdomen) pain
• Problems in other organs. Signs and symptoms may include:
  • severe muscle weakness
  • numbness or tingling in hands or feet
  • confusion
  • blurry vision, double vision, or other vision problems
  • changes in mood or behavior
  • extreme sensitivity to light
  • neck stiffness
  • eye pain or redness
  • skin blisters or peeling
  • chest pain, irregular heartbeat, shortness of breath or swelling of the ankles
• Severe infections. Signs and symptoms of infection may include:
  • fever
  • cough
  • flu-like symptoms
  • pain when urinating, frequent urination or back pain
• Severe infusion reactions. Signs and symptoms of infusion reactions may include:
  • chills or shaking
  • itching or rash
  • flushing
  • shortness of breath or wheezing
  • swelling of your face or lips
  • dizziness
  • fever
  • feeling like passing out
  • back or neck pain

Getting medical treatment right away may help keep these problems from becoming more serious.

Your healthcare provider will check you for these problems during your treatment with Tecentriq. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may delay or completely stop treatment with Tecentriq if you have severe side effects.

What should I tell my healthcare provider before using Tecentriq?

Before you receive Tecentriq, tell your healthcare provider about all of your medical conditions, including if you:

• have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus
• have had an organ transplant
• have lung or breathing problems
• have liver problems
• have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome
• are being treated for an infection
• are pregnant or plan to become pregnant. Tecentriq can harm your unborn baby. Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with Tecentriq.
  Females who are able to become pregnant:
  • Your healthcare provider should do a pregnancy test before you start treatment with Tecentriq.
  • You should use an effective method of birth control during your treatment and for at least 5 months after the last dose of Tecentriq.
• are breastfeeding or plan to breastfeed. It is not known if Tecentriq passes into your breast milk. Do not breastfeed during treatment and for at least 5 months after the last dose of Tecentriq.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

How should I use Tecentriq?

• Your healthcare provider will give you Tecentriq into your vein through an intravenous (IV) line over 30 to 60 minutes.
• Tecentriq is usually given every 2, 3, or 4 weeks.
• Your healthcare provider will decide how many treatments you need.
• Your healthcare provider will test your blood to check you for certain side effects.
• For treatment of a type of skin cancer called melanoma, your healthcare provider will also prescribe you cobimetinib and vemurafenib. Take cobimetinib and vemurafenib exactly as your healthcare provider tells you.
• If you miss any appointments, call your healthcare provider as soon as possible to reschedule your appointment.

What are the possible side effects of Tecentriq?

Tecentriq can cause serious side effects, including:

• See “What is the most important information I should know about Tecentriq?”

The most common side effects of Tecentriq when used alone include:

• feeling tired or weak
• nausea
• cough
• shortness of breath
• decreased appetite

The most common side effects of Tecentriq when used in lung cancer with other anti-cancer medicines include:

• feeling tired or weak
• nausea
• hair loss
• constipation
• diarrhea
• decreased appetite

The most common side effects of Tecentriq when used in triple-negative breast cancer with paclitaxel protein-bound include:

• hair loss
• tingling or numbness in hands or feet
• feeling tired
• nausea
• diarrhea
• low red blood cells (anemia)
• constipation
• cough
• headache
• low white blood cells
• vomiting
• decreased appetite

The most common side effects of Tecentriq when used in hepatocellular carcinoma with bevacizumab include:

• high blood pressure
• feeling tired or weak
• too much protein in the urine

The most common side effects of Tecentriq when used in melanoma with cobimetinib and vemurafenib include:

• skin rash
• joint, muscle, or bone pain
• feeling tired or weak
• liver injury
• fever
• nausea
• itching
• swelling of legs or arms
• mouth swelling (sometimes with sores)
• low thyroid hormone levels
• sunburn or sun sensitivity

Tecentriq may cause fertility problems in females, which may affect the ability to have children. Talk to your healthcare provider if you have concerns about fertility.

These are not all the possible side effects of Tecentriq. Ask your healthcare provider or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

General information about the safe and effective use of Tecentriq

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. If you would like more information about Tecentriq, talk with your healthcare provider. You can ask your healthcare provider for information about Tecentriq that is written for health professionals.

What are the ingredients in Tecentriq?

Active ingredient: atezolizumab

Inactive ingredients: glacial acetic acid, L-histidine, polysorbate 20 and sucrose

Label

PRINCIPAL DISPLAY PANEL – 20 ML VIAL CARTON

• NDC 50242-917-01
• Tecentriq®
  (atezolizumab)
  Injection
• 1200 mg/20 mL
  (60 mg/mL)
• For Intravenous Infusion After Dilution
  Single-Dose Vial
  Discard Unused Portion
  No preservative.
• Attention Pharmacist: Dispense the
  accompanying Medication Guide
  to each patient.
• 1 vial
• Rx only
• Genentech
• 10199144

PRINCIPAL DISPLAY PANEL – 14 ML VIAL CARTON

• NDC 50242-918-01
• Tecentriq®
  (atezolizumab)
  Injection
• 840 mg/14 mL
  (60 mg/mL)
• For Intravenous Infusion After Dilution
  Single-Dose Vial
  Discard Unused Portion
  No preservative.
• Attention Pharmacist: Dispense the
  accompanying Medication Guide
  to each patient.
• 1 vial
• Rx only
  Genentech
• 10198487

SRC: NLM .