Atezolizumab is a programmed death ligand 1 (PD-L1) monoclonal antibody. It acts by activating the anti-tumor immune response and is prescribed for the treatment of advanced or metastatic urothelial carcinoma (a type of cancer which affects the urinary bladder and its related parts). Metastatic cancer refers to a cancer that has spread to distant parts of the body. Atezolizumab is approved for use in patients who have disease progression.
• During or following chemotherapy which contains a platinum-based drug in the regimen.
• With platinum-based chemotherapy administered either before or after surgery for the cancer.
The use of atezolizumab may have to be discontinued in patients who are allergic to the drug, or experience severe immune-related side effects that result in inflammation of the lung, liver, colon, hormone-secreting glands or other organs, infections or nervous disorders like myasthenia gravis during treatment. It should not be administered during pregnancy and breastfeeding.
The recommended dose of atezolizumab is 1200mg to be administered over one hour in the form of an intravenous infusion for every 3 weeks. If the first infusion is tolerated without adverse reactions, the following infusions can be given over 30 minutes. Atezolizumab should not be administered as an intravenous push or bolus.
Atezolizumab comes in the form of an intravenous injection to be diluted in 0.9% sodium chloride and administered into the vein. Do not co-administer other drugs in the same infusion line.
• General: Fatigue, fever and peripheral edema (accumulation of fluid which result in swelling).
• Gastrointestinal: Nausea, vomiting, constipation, diarrhea, abdominal pain, decreased appetite.
• Musculoskeletal system: Neck pain, back pain and joint pain.
• Respiratory system: Difficulty in breathing and cough.
• Kidney and Urinary system: Hematuria (blood in urine) and urinary tract infections.
• Skin: Rash and severe itching of the skin.
• Immune-related side effects: These side effects include inflammation of organs like lungs, liver, colon and hormone-secreting glands (endocrine organs).
• Patients must be advised to consult the doctor if there is any sign of myasthenia gravis (neuromuscular disease), meningoencephalitis (inflammation of brain and its surrounding membranes) and Gullian Barre syndrome (immune related nervous disorder) after taking atezolizumab.
• Do not breastfeed while taking atezolizumab and leave a gap of at least five months after the last dose before breastfeeding the baby.
• While diluting the infusion, atezolizumab should be mixed only by gentle inversion, do not shake.
• The empty and partially used vials should be discarded immediately. They must not be reused after opening.
There are no known drug interactions with atezolizumab.
Atezolizumab does not contain any preservative and therefore should be administered immediately after preparation. If diluted, it has to be stored at room temperature for not more than 6 hours following the preparation. It can be stored in a refrigerator at 2°C - 8°C for not more than 24 hours. Do not freeze and do not shake.