Atezolizumab

From WikiMD

atezolizumab (A-teh-zoh-LIZ-yoo-mab) is a drug used with bevacizumab, paclitaxel, and carboplatin to treat non-squamous non-small cell lung cancer (NSCLC) that has spread to other parts of the body and has not been treated. It is used in patients whose cancer does not have a mutation (change) in the EGFR or ALK genes.

Other cancers

Atezolizumab is also used to treat certain types of NSCLC and urothelial cancer (a type of bladder cancer) that have advanced or spread to other parts of the body and cannot be treated with or have gotten worse during or after treatment with anticancer drugs that included platinum. It is also being studied in the treatment of other types of cancer.

How does it work?

It is a type of monoclonal antibody and a type of immune checkpoint inhibitor.

Other names

Also called Tecentriq.

Information about Atezolizumab

Atezolizumab is a humanized monoclonal antibody to programmed death-ligand 1 (PD-L1) that increases immune reactivity to tumor neoantigens and is used as immunotherapy of selected cancers of the bladder and lung. 

Liver safety of Atezolizumab

Atezolizumab has been associated with a low rate of serum enzyme elevations during therapy and with uncommon instances of clinically apparent, immune-mediated liver injury.

Mechanism of action of Atezolizumab

Atezolizumab (a" te zoe liz' ue mab) is a humanized monoclonal immunoglobulin G1 antibody to the programmed cell death ligand 1 (PD-L1) that is used in cancer immunotherapy. Inhibition of PD-L1 overcomes the usual block ("check point") in immune surveillance of tumor cell neoantigens and can induce remissions in several forms of advanced, metastatic cancer including urothelial (bladder and urethral) carcinoma and non-small cell lung cancer (NSCLC).  In clinical trials, atezolizumab led to prolongation of recurrence free survival as well as overall survival in patients with bladder cancer and NSCLC.  Response rates to atezolizumab were somewhat higher in patients who expressed high levels of PD-L1 in tumor-infiltrating immune cells. 

FDA approval information for Atezolizumab

Atezolizumab was approved for use in the United States in 2016, the fourth monoclonal antibody check point inhibitor introduced into cancer immunotherapy, the others being ipilimumab (anti-CTLA-4: 2011), pembrolizumab (anti-PD-1: 2014), and nivolumab (anti-PD-1: 2015).  Atezolizumab is available in single use vials of 1200 mg (in 20 mL) and the recommended dose is 1200 mg intravenously every 3 weeks. 

Side effects of Atezolizumab

Adverse events can include fatigue, nausea, anorexia, diarrhea, fever, dyspnea and rash.  Most challenging, however, are the various immune-mediated adverse events such as hypothyroidism, colitis, pneumonitis and hepatitis.  Early recognition and prompt management of these side effects (usually with corticosteroids) is an integral component of proper use of check point inhibitors.

 

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