Atezolizumab Treatment: Dosage, Benefits, and Side Effects Explained

Summary of Key Points

Atezolizumab is an immunotherapy used to treat various cancers, including lung, bladder, and breast cancer. It works by helping your immune system recognize and attack cancer cells. Atezolizumab is administered as an intravenous (IV) infusion under the supervision of a healthcare provider. Side effects can range from mild to severe, so it’s important to discuss any concerns with your doctor. You can also consult one of our telemedicine providers for further guidance.

Names of Medication

US Brand Name: Tecentriq (Atezolizumab)

The generic name refers to the chemical composition of the medication, while the brand name is the marketed version. In this case, the generic name is listed in parentheses.

Pharmacologic Category

Programmed Death-Ligand 1 (PD-L1) Inhibitor

Immunotherapy

Atezolizumab Dosing

Atezolizumab is used to treat several types of cancer in adults. The dosing schedule varies depending on the type of cancer being treated. Always follow your doctor’s instructions and never adjust your dose without consulting your healthcare provider. If you need assistance, our telemedicine service is available to help.

Atezolizumab Dosage for Different Cancers

1. Non-Small Cell Lung Cancer (NSCLC): 1200 mg IV every 3 weeks or 840 mg IV every 2 weeks. Treatment continues until disease progression or unacceptable toxicity.
2. Small Cell Lung Cancer (SCLC): 1200 mg IV every 3 weeks in combination with chemotherapy. Treatment continues until disease progression or unacceptable toxicity.
3. Urothelial Carcinoma (Bladder Cancer): 1200 mg IV every 3 weeks. Treatment continues until disease progression or unacceptable toxicity.
4. Triple-Negative Breast Cancer (TNBC): 840 mg IV every 2 weeks in combination with chemotherapy. Treatment continues until disease progression or unacceptable toxicity.
5. Hepatocellular Carcinoma (Liver Cancer): 1200 mg IV every 3 weeks in combination with bevacizumab. Treatment continues until disease progression or unacceptable toxicity.
6. Renal Cell Carcinoma (Kidney Cancer): 1200 mg IV every 3 weeks in combination with bevacizumab. Treatment continues until disease progression or unacceptable toxicity.
7. Melanoma: 840 mg IV every 2 weeks or 1200 mg IV every 3 weeks. Treatment continues until disease progression or unacceptable toxicity.
8. Esophageal Cancer: 1200 mg IV every 3 weeks. Treatment continues until disease progression or unacceptable toxicity.
9. Gastric Cancer: 1200 mg IV every 3 weeks. Treatment continues until disease progression or unacceptable toxicity.
10. Cervical Cancer: 1200 mg IV every 3 weeks. Treatment continues until disease progression or unacceptable toxicity.

Dosage Forms and Strengths

1. Injection, solution: 840 mg/14 mL (60 mg/mL)
2. Injection, solution: 1200 mg/20 mL (60 mg/mL)

Administration Instructions for Atezolizumab

Atezolizumab is administered as an intravenous (IV) infusion, delivered directly into a vein. The infusion typically lasts 30 to 60 minutes. It is essential to receive this medication under the supervision of a healthcare provider. Do not attempt to administer it yourself. If you experience any side effects during the infusion, notify your healthcare provider immediately.

Adverse Reactions and Side Effects of Atezolizumab

Like all medications, Atezolizumab can cause side effects. Some are common, while others are rare but serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers for advice.

Common Atezolizumab Side Effects

These occur in more than 10% of patients and include:

1. Fatigue
2. Nausea
3. Cough
4. Shortness of breath
5. Decreased appetite

Less Common Side Effects

These occur in 1-10% of patients and include:

1. Diarrhea
2. Rash
3. Fever
4. Joint pain

Serious Side Effects

These are rare but may include severe immune-related reactions such as:

1. Inflammation of the lungs (pneumonitis)
2. Inflammation of the liver (hepatitis)
3. Inflammation of the colon (colitis)

These require immediate medical attention.

Contraindications for Atezolizumab

A contraindication is a specific condition where a particular treatment or medication should not be used due to potential harm. For Atezolizumab, certain conditions may increase the risk of serious side effects or complications.

Contraindications for Atezolizumab Treatment

1. Severe allergic reactions to Atezolizumab or its ingredients: If you’ve had a serious allergic reaction (such as anaphylaxis) to Atezolizumab or its components, it is unsafe to take this medication again. Allergic reactions can be life-threatening.
2. Autoimmune diseases: Atezolizumab stimulates the immune system to attack cancer cells. However, if you have an autoimmune disease (like lupus or rheumatoid arthritis), this stimulation could worsen your condition by causing your immune system to attack healthy tissues.
3. Active infections: If you have an active infection, especially tuberculosis or hepatitis, Atezolizumab could further weaken your immune system, making it harder to fight off the infection.
4. Organ transplant recipients: Atezolizumab may increase the risk of organ rejection in transplant patients, as it can stimulate the immune system to attack the transplanted tissue.

Drug-to-Drug Interactions with Atezolizumab

It’s essential to inform your healthcare provider about all medications you are taking, as some drugs may interact with Atezolizumab, potentially causing harmful effects or reducing the effectiveness of your treatment.

Medications That May Interact with Atezolizumab

1. Corticosteroids (Prednisone, Dexamethasone): These medications suppress the immune system, which may counteract Atezolizumab’s effects, as it works by enhancing immune activity.
2. Immunosuppressants (Tacrolimus, Cyclosporine): These drugs, often used in transplant patients or those with autoimmune diseases, can interfere with Atezolizumab’s mechanism of action, increasing the risk of organ rejection or worsening autoimmune conditions.
3. Live vaccines: Vaccines containing live, weakened viruses (such as the MMR vaccine) may not be safe while on Atezolizumab, as the medication weakens your immune system, increasing the risk of infection from the vaccine.

Atezolizumab in Pregnancy

Is it Safe to Take Atezolizumab During Pregnancy?

Atezolizumab, also known as Tecentriq, is generally not recommended during pregnancy unless absolutely necessary. This immunotherapy drug can potentially harm an unborn baby, as it affects the immune system, which plays a vital role in pregnancy. If you are pregnant or planning to become pregnant, it’s crucial to discuss your options with your healthcare provider. They can help you carefully weigh the risks and benefits of continuing Atezolizumab treatment. If you are already taking Atezolizumab and discover you are pregnant, contact your healthcare provider immediately for guidance.

Atezolizumab While Breastfeeding

Is it Safe to Take Atezolizumab While Breastfeeding?

It is currently unclear whether Atezolizumab passes into breast milk. However, due to the potential risk of serious side effects in a nursing infant, breastfeeding is generally not recommended while undergoing Atezolizumab therapy. If you are breastfeeding or planning to breastfeed, it’s important to consult your healthcare provider. They may suggest alternative treatments or advise you to temporarily stop breastfeeding while receiving Atezolizumab.

Estimated Cost of Atezolizumab

The cost of Atezolizumab can vary depending on your location and pharmacy. Without insurance, the estimated cost for a 30-day supply using a GoodRx coupon ranges from approximately $12,000 to $13,000. It’s a good idea to check with your pharmacy for the most accurate pricing. Additionally, there may be financial assistance programs available to help reduce the cost of your treatment.

Possible Alternatives to Atezolizumab

If Atezolizumab is not the right option for you, other treatments and lifestyle changes may help manage your condition. Always discuss any changes to your treatment plan with your healthcare provider. You can also schedule a telemedicine appointment with one of our providers to explore these alternatives.

Non-Small Cell Lung Cancer

Alternative Medications: Pembrolizumab (Keytruda), Nivolumab (Opdivo), Chemotherapy (Cisplatin, Carboplatin)

Lifestyle Changes: Quitting smoking, maintaining a balanced diet, and engaging in regular physical activity can improve overall health and may reduce the risk of cancer progression.

Small Cell Lung Cancer

Alternative Medications: Durvalumab (Imfinzi), Chemotherapy (Etoposide, Carboplatin)

Lifestyle Changes: Smoking cessation and pulmonary rehabilitation can enhance lung function and improve quality of life.

Urothelial Carcinoma

Alternative Medications: Pembrolizumab (Keytruda), Nivolumab (Opdivo), Chemotherapy (Cisplatin, Gemcitabine)

Lifestyle Changes: Staying hydrated, avoiding tobacco, and maintaining a healthy weight may help lower the risk of recurrence.

Triple-Negative Breast Cancer

Alternative Medications: Pembrolizumab (Keytruda), Chemotherapy (Paclitaxel, Doxorubicin)

Lifestyle Changes: Regular exercise, a nutritious diet, and limiting alcohol intake may improve overall health and support treatment outcomes.

Hepatocellular Carcinoma

Alternative Medications: Sorafenib (Nexavar), Lenvatinib (Lenvima)

Lifestyle Changes: Avoiding alcohol, maintaining a healthy weight, and managing underlying liver conditions, such as hepatitis, can promote liver health.

Renal Cell Carcinoma

Alternative Medications: Nivolumab (Opdivo), Pembrolizumab (Keytruda), Sunitinib (Sutent)

Lifestyle Changes: Staying physically active, eating a balanced diet, and managing blood pressure may help improve kidney function and overall well-being.

Melanoma

Alternative Medications: Pembrolizumab (Keytruda), Nivolumab (Opdivo), Ipilimumab (Yervoy)

Lifestyle Changes: Protecting your skin from UV exposure and performing regular skin checks can help prevent melanoma and detect it early.

Esophageal Cancer

Alternative Medications: Pembrolizumab (Keytruda), Chemotherapy (Cisplatin, Fluorouracil)

Lifestyle Changes: Avoiding tobacco and alcohol, maintaining a healthy weight, and following a balanced diet may help reduce the risk of esophageal cancer.

Gastric Cancer

Alternative Medications: Pembrolizumab (Keytruda), Chemotherapy (Cisplatin, Capecitabine)

Lifestyle Changes: Eating a diet rich in fruits and vegetables, avoiding processed foods, and maintaining a healthy weight may help lower the risk of gastric cancer.

Cervical Cancer

Alternative Medications: Pembrolizumab (Keytruda), Chemotherapy (Cisplatin, Paclitaxel)

Lifestyle Changes: Regular Pap smears, HPV vaccination, and practicing safe sex can help prevent cervical cancer.

Recent Updates on Atezolizumab Research

Recent studies have shown promising results for Atezolizumab when used in combination with other therapies. Ongoing research is exploring its use alongside targeted therapies and chemotherapy in various cancers, including non-small cell lung cancer and triple-negative breast cancer. Additionally, clinical trials are investigating its effectiveness in earlier stages of cancer, potentially expanding its use beyond advanced or metastatic disease. As research progresses, more data will become available on the long-term benefits and potential new applications for Atezolizumab.

If you are interested in learning more about these studies or participating in a clinical trial, discuss this with your healthcare provider. You can also schedule a telemedicine appointment with one of our providers to explore your options.

James Kingsley

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