Drug updated on 12/11/2024
| Dosage Form | Injection (intravenous; 840 mg/14 mL [60 mg/mL], 1200 mg/20 mL [60 mg/mL]) |
| Drug Class | human programmed death receptor-1 (PD-1)-blocking antibodies |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated as adjuvant treatment following resection and platinum-based chemotherapy for adult patients with stage II to IIIA non-small cell lung cancer (NSCLC) whose tumors have PD-L1 expression on 1% of tumor cells, as determined by an FDA-approved test
- Indicated for the first-line treatment of adult patients with metastatic NSCLC whose tumors have high PD-L1 expression (PD-L1 stained 50% of tumor cells [TC 50%] or PD-L1 stained tumor-infiltrating immune cells [IC] covering 10% of the tumor area [IC 10%]), as determined by an FDA approved test, with no EGFR or ALK genomic tumor aberrations
- Indicated in combination with bevacizumab, paclitaxel, and carboplatin, for the first line treatment of adult patients with metastatic non-squamous NSCLC with no EGFR or ALK genomic tumor aberrations
- Indicated in combination with paclitaxel protein-bound and carboplatin for the first line treatment of adult patients with metastatic non-squamous NSCLC with no EGFR or ALK genomic tumor aberrations
- Indicated for the treatment of adult patients with metastatic NSCLC who have disease progression during or following platinum-containing chemotherapy
- Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for NSCLC harboring these aberrations prior to receiving Tecentriq
- Indicated in combination with carboplatin and etoposide, for the first-line treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC)
- Indicated in combination with bevacizumab for the treatment of patients with unresectable or metastatic hepatocellular carcinoma (HCC) who have not received prior systemic therapy
- Indicated in combination with cobimetinib and vemurafenib for the treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma
- Indicated for the treatment of adult and pediatric patients 2 years of age and older with unresectable or metastatic alveolar soft part sarcoma (ASPS).
Latest News
Summary
- This summary is based on the review of 87 systematic review(s)/meta-analysis(es). [1-87]
- Hepatocellular Carcinoma (HCC): Atezolizumab combined with bevacizumab demonstrated superior overall survival (OS) and progression-free survival (PFS) compared to sorafenib in advanced HCC, consistently ranking as one of the most effective first-line treatments. This combination also outperformed lenvatinib in terms of OS and has been highlighted in systematic reviews and network meta-analyses as offering the best overall effectiveness in HCC.
- Non-Small Cell Lung Cancer (NSCLC): In advanced non-squamous NSCLC, atezolizumab combined with chemotherapy improved both OS and PFS compared to chemotherapy alone, though atezolizumab monotherapy showed lower efficacy, particularly in programed death ligand 1 (PD-L1) high expressors. For this subgroup, pembrolizumab combined with chemotherapy generally ranked higher in efficacy compared to atezolizumab plus chemotherapy.
- Small Cell Lung Cancer (SCLC): In extensive-stage SCLC, the combination of atezolizumab with chemotherapy demonstrated improved OS and PFS over chemotherapy alone. This combination was generally favored over other immune checkpoint inhibitors (ICIs) like durvalumab for efficacy outcomes in extensive-stage SCLC.
- Comparative Effectiveness in Key Cancer Types: For HCC, atezolizumab plus bevacizumab showed superior outcomes in OS and PFS compared to both sorafenib and lenvatinib. In NSCLC, pembrolizumab plus chemotherapy was generally more effective for PD-L1 high expressors, while in SCLC, atezolizumab plus chemotherapy was more effective in enhancing OS and PFS compared to durvalumab with chemotherapy.
- HCC: In patients treated with atezolizumab plus bevacizumab, adverse events were reported more frequently, particularly grade 3 or higher events in Child-Pugh B patients compared to Child-Pugh A patients. Common adverse events included hypertension and proteinuria, suggesting that the Child-Pugh B group may require close monitoring for adverse effects.
- NSCLC: Atezolizumab combined with chemotherapy led to increased treatment-related adverse events, especially grade 3-5 events, compared to chemotherapy alone. The most common adverse events were respiratory issues, endocrinological effects, and skin reactions.
- Small Cell Lung Cancer (SCLC): When combined with chemotherapy, atezolizumab was associated with a higher incidence of adverse events than chemotherapy alone, including neutropenia, anemia, and fatigue. Hematological toxicities were notably frequent, indicating a need for regular monitoring.
- Comparative Safety Across Indications: For HCC, atezolizumab plus bevacizumab showed a higher incidence of adverse events than sorafenib. In NSCLC, atezolizumab combined with chemotherapy had comparable but elevated rates of specific adverse events (e.g., hypertension) relative to pembrolizumab plus chemotherapy. In SCLC, the safety profile of atezolizumab with chemotherapy was similar to that of durvalumab with chemotherapy.
- HCC: Patients with viral hepatitis demonstrated better responses to immune checkpoint inhibitor (ICI)-based therapies, particularly with the combination of atezolizumab and bevacizumab. However, Child-Pugh B patients experienced higher rates of adverse events and had shorter progression-free survival (PFS) and OS compared to Child-Pugh A patients, indicating a need for cautious monitoring in the Child-Pugh B group.
- NSCLC: Efficacy of atezolizumab was consistent across age groups, with no significant differences in outcomes between patients aged 75 years and older and younger patients, though older patients experienced more adverse events. Additionally, patients with high PD-L1 expression levels responded more favorably to atezolizumab combined with chemotherapy, indicating that PD-L1 expression status may guide treatment decisions.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Tecentriq (atezolizumab) Prescribing Information. | 2024 | Genentech, Inc., South San Francisco, CA |