Treatment Name: Atezolizumab (Tecentriq®)
How does atezolizumab work?
Atezolizumab for lung cancer is designed to enhance your immune system’s ability to target and specifically kill lung cancer cells. Sometimes cancer cells have the ability to escape discovery from specific cancer-fighting cells known as T-cells. By attaching to lunch cancer cells, atezolizumab helps your body’s T-cells recognize the cancer and kill it.
Goals of therapy:
Atezolizumab is given to patients who have had lung cancer progression (worsening) during or following platinum-containing chemotherapy or progression after therapy that targets EGFR or ALK mutations. Atezolizumab is given to patients with the goal of shrinking lung cancer tumors, decreasing symptoms, and prolonging survival and is not commonly given with the goal of cure.
- Atezolizumab intravenous (I.V.) infusion over 60 minutes on Day 1
- If the first infusion is well tolerated, the following infusions may be given over 30 minutes
Estimated total infusion time for this treatment:
- Up to one hour for Cycle 1, Day 1; as short as 30 minutes for Day 1 of next cycles if well tolerated
- Infusion times are based on clinical studies, but may vary depending on doctor preference or patient tolerability. Pre-medications and intravenous (I.V.) fluids, such as hydration, may add more time
Atezolizumab is usually given in an outpatient infusion center, allowing the person to go home afterwards.
Atezolizumab is repeated every 14, 21, or 28 days. This is known as one Cycle. Each cycle may be repeated until the drug no longer works or until unacceptable side effects occur. Duration of therapy depends upon response, tolerability, and number of cycles prescribed.
Click here for the common atezolizumab (Tecentriq®) starting doses.
In a multi-drug regimen, each medication has unique side effects. When these medicines are given together, drug-related side effects reported in clinical studies give the best estimate of what to expect. In clinical studies, the most commonly reported atezolizumab (Tecentriq) side effects of are shown here:
A note about side effect percentages
- Fatigue (27%)
- Decreased appetite (24%)
- Cough (23%)
- Weakness (19%)
- Shortness of breath (19%)
- Nausea (18%)
- Constipation (18%)
- Fever (18%)
- Diarrhea (15%)
- Low red blood cells [Anemia] (12%)
- Vomiting (12%)
- Joint pain (12%)
- General muscle or bone pain (11%)
- Back pain (11%)
- Swelling in legs or arms (9%)
- Muscle aches (6%)
- Tingling or numbness in fingers or toes (4%)
- Mouth sores (3%)
- Changes in taste (3%)
- Low white blood cells [Neutropenia] (2%)
- Neutropenic fever (<1%)
On average, 8% of patients discontinue atezolizumab treatment due to unacceptable side effects.
Importantly, not all people who experience a side effect from Tecentriq® (atezolizumab) will experience it in the same way. It may be mild in some or severe in others, depending upon the individual. Everybody is different. Additionally, side effects may vary over time. For some, side effects may be a reason to delay or switch treatment, reduce the dose, or avoid future treatment with a certain medication altogether.
Side effects may be treatable when they occur or preventable by taking certain medications before they happen. When medications are taken to prevent a problem, this is known as prophylaxis, or "prophy" for short.
After starting treatment with Tecentriq® (atezolizumab), be sure to come back and watch all of the side effect videos shown below. Each of these videos contain valuable information about side effect management that will hopefully help you to both feel better and stay out of the hospital.
How often is monitoring needed?
Labs (blood tests) may be checked before treatment and periodically during atezolizumab (Tecentriq) treatment. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), thyroid function, blood amylase levels, blood lipase levels, plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked before treatment and during atezolizumab treatment if there are concerns for disease progression or side effects. Imaging may include: X-rays, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue atezolizumab as planned, delay the next dose until the side effect goes away, or switch to an alternative therapy. If atezolizumab side effects occur, a delay or change in therapy may be recommended; however, decreasing the dose of atezolizumab is not usually recommended.
- Because atezolizumab (Tecentriq®) enhances your immune system response to cancer, it may cause unintended side effects that are caused by the immune system and affect healthy cells as well. Some organs that can be affected include the thyroid, pituitary gland, adrenal glands, pancreas, gastrointestinal tract, liver, lungs, skin and eyes. A corticosteroid (e.g., prednisone) may be prescribed by your doctor to decrease symptoms if the immune system attacks healthy tissues during treatment
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for NSCLC. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Atezolizumab (Tecentriq®), we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Atezolizumab (Tecentriq®). Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Atezolizumab (Tecentriq®) and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with Atezolizumab (Tecentriq®)