atezolizumab, Tecentriq

 Indications

Locally advanced or metastatic urothelial carcinoma in

patients who are not eligible for cisplatin-containing

chemotherapy or have disease progression during or

following platinum-containing chemotherapy or have

disease progression within 12 mo of neoadjuvant or adjuvant

chemotherapy. Metastatic non-small cell lung

cancer (NSCLC) in patients who have disease progression

during or following platinum-containing chemotherapy.

Patients with epidermal growth factor receptor

(EGFR) or anaplastic lymphoma kinase (ALK) genomic

tumor aberrations should have disease progression on

FDA-approved therapy for these aberrations prior to receiving

atezolizumab.

Action

Binds to programmed death ligand 1 (PD-L1) to prevent

its interaction with the programmed cell death-1

(PD-1) and B7.1 (or CD80) receptors, which activates

the anti-tumor immune response. Therapeutic Effects:

Decreased spread of urothelial carcinoma; decreased

spread of NSCLC with increased survival. 

Pharmacokinetics A

Absorption: IV administration results in complete

bioavailability.

Distribution: Minimally distributed to tissues.

Metabolism and Excretion: Unknown.

Half-life: 27 days.

TIME/ACTION PROFILE (blood levels)

ROUTE ONSET PEAK DURATION

IV unknown unknown unknown

Contraindications/Precautions

Contraindicated in: OB: May cause fetal harm;

Lactation: Breast feeding should be avoided during

treatment and for 5 mo after therapy.

Use Cautiously in: Rep: Patients with childbearing

potential; Pedi: Safety and effectiveness not established.

Adverse Reactions/Side Effects

CV: peripheral edema. CNS: ENCEPHALITIS, MENINGITIS.

Derm: pruritus, rash. Endo: adrenal insufficiency,

hyperglycemia, hyperthyroidism, hypophysitis, hypothyroidism,

type 1 diabetes mellitus. F and E: hyponatremia,

dehydration. GI: COLITIS/DIARRHEA, HEPATOTOXICITY,

PANCREATITIS, constipation,pappetite, nausea,

vomiting, abdominal pain,qliver enzymes. GU: hematuria,

acute kidney injury,pfertility,qserum creatinine,

urinary obstruction. Hemat: lymphopenia, anemia.

Metab: hypoalbuminemia. MS: arthralgias,q

alkaline phosphatase. Neuro: GUILLAIN-BARRE SYNDROME,

MYASTHENIA GRAVIS. Resp: INTERSTITIAL LUNG

DISEASE, cough, dyspnea. Misc: INFECTIONS (including

herpes encephalitis and tuberculosis), fatigue, fever, infusion-

related reactions.

Interactions

Drug-Drug: None known.

Route/Dosage

IV (Adults): 1200 mg every 3 wk until disease progression

or unacceptable toxicity.

Availability

Solution for injection (requires dilution): 60 mg/

mL.