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Treatment Name: Atezolizumab (Tecentriq®)

Atezolizumab (Tecentriq®) is an Immunotherapy Regimen for Lung Cancer, Non-Small Cell Lung Cancer (NSCLC)

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.


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  • 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.

Side Effects

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.

Side effect videos Side Effect Videos
Fatigue Fatigue Nausea and VomitingNausea and VomitingConstipationConstipationDiarrheaDiarrheaAnemiaAnemiaPainPainNeutropenic FeverNeutropenic Fever


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.

ChemoExperts Tips

  • 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 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:

  • Atezolizumab

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.

Emotional Wellness

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®)

Individual Drug Label Information

Atezolizumab (Tecentriq®)

  • Atezolizumab (Tecentriq®) is an intravenous infusion
  • Doses may need to be delayed due to lung, liver, intestine, adrenal gland, thyroid, pituitary, eye, or other treatment-related problems
  • Inflammation of the lungs is rare, but serious if it occurs. Call your doctor immediately if you notice change in breathing, worsening cough, or chest pain as immediate treatment may be necessary
  • Liver inflammation may occur and is usually found through blood tests and may not cause any symptoms early in treatment. Atezolizumab therapy may need to be put on hold if this occurs, or steroid treatment may be started to help the liver recover. It may be possible to restart atezolizumab treatment if the liver fully recovers. Signs of liver problems may include yellowing of eyes or skin, pain on right side of abdomen, or easy bruising or bleeding
  • Intestine (colon) inflammation is relatively common and often causes diarrhea, with or without abdominal pain. Atezolizumab therapy may need to be put on hold if this occurs, or steroid treatment may be started to help the intestines recover. It may be possible to restart atezolizumab treatment if the intestines recover
  • Thyroid, adrenal gland, pancreas, or pituitary gland inflammation may occur, although all are relatively rare and occur in roughly 4% or fewer patients (1 out of every 25 patients)
  • Symptoms of thyroid problems may include: extreme tiredness, hair loss, weight loss or weight gain, feeling cold
  • Symptoms of adrenal gland problems may include: Dizziness, fatigue, low blood pressure, low blood sugar, difficulty with walking
  • Symptoms of pancreas problems may include: blood sugars that are difficult to control or abdominal pain, or frequent urination
  • Symptoms of pituitary gland problems may include: headache, vision problems, changes in hair, nails, or skin, and problems with other glands such as adrenals
  • Atezolizumab may be unsafe to receive if you are pregnant or breastfeeding. If you are a woman of child-bearing potential, tell you doctor immediately if you become pregnant while receiving atezolizumab. Women should not breastfeed for at least five months after the last dose of therapy
  • Women should also use effective contraception during treatment and for at least five months after the last dose
General side effects from atezolizumab (Tecentriq®)
  • Fatigue is the most common side effect reported with atezolizumab
  • Decreased appetite
  • Nausea
  • Infection, such as urinary tract infections or others. Report any fever, chills, flu-like symptoms, cough, or pain when urinating to your doctor immediately
  • Constipation
  • Skin reactions, such as itching or rash
  • Diarrhea is most often mild, but in some cases it can become severe when the digestive tract becomes inflamed. Watch for blood in stool or black tarry stools
  • Pain in joints
  • Vision problems
  • Click on the atezolizumab (Tecentriq®) package insert below for all reported side effects and possible drug interactions

Side Effect Videos
Nausea and VomitingNausea and VomitingDiarrheaDiarrheaFatigue Fatigue ConstipationConstipationPainPainAnemiaAnemia

See DailyMed package insert.

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1) Rittmeyer A, Barlesi F, Waterkamp D, et al. Atezolizumab versus docetaxel in patients with previously treated non small cell lung cancer (OAK): a phase 3, open label, multicentre randomised controlled trial. Lancet. 2017;389:255-265.

Created: March 11, 2019 Updated: January 15, 2020

What is Lung Cancer, Non-Small Cell Lung Cancer (NSCLC)?

What is Non-Small Cell Lung Cancer?
A disease of the tissue found in the lung.  Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. Known causes include smoking and exposure to environmental toxins.  The stage of NSCLC can vary at diagnosis and throughout treatment.  Stages include stage I, II, III, and IV.  The effectiveness of the treatment may depend upon the stage at diagnosis.

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose which therapy is appropriate for you.

Common Atezolizumab (Tecentriq®) starting doses

  • Atezolizumab 840 mg intravenous (I.V.) infusion over 60 minutes on Day 1 every 14 days, OR
  • Atezolizumab 1200 mg intravenous (I.V.) infusion over 60 minutes on Day 1 every 21 days, OR
  • Atezolizumab 1680 mg intravenous (I.V.) infusion over 60 minutes on Day 1 every 28 days

If the first infusion is well tolerated, subsequent infusions may be given over 30 minutes

Note: Individual doses may vary based upon your Doctor's recommendation, or drug availability.

What does Cure mean?

The word “cure” means there are no cancer cells left in the body and cancer will never come back. Depending on the cancer type and stage, this may be the true goal of therapy. However, it is very difficult to prove all cancer cells are gone. Even though images, like X-rays and MRI’s, and blood tests may not show any signs of cancer, there can be a small amount of cancer cells still left in the body. Because of this, the word “remission” is used more often. This means there are no signs or symptoms of cancer. Patients in remission are followed closely for any signs of cancer returning. Sometimes, more chemotherapy may be given while in remission to prevent the cancer from coming back.

Doctors usually do not consider a patient “cured” until the chance of cancer returning is extremely low. If cancer does return, it usually happens within 5 years of having a remission. Because of this, doctors do not consider a patient cured unless the cancer has not come back within 5 years of remission. The five-year cutoff does not apply to all cancers.

What is a CBC?

A Complete Blood Count (CBC) is a frequently ordered blood test that tells clinicians the status of your: 1) White blood cell count, 2) Hemoglobin, and 3) Platelet count at the time the test was taken.

Common uses:
1) White blood cell count (WBC): is used to determine infection risk, or response to chemotherapy. Certain chemotherapy agents may harm our good infection-fighting cells. Sometimes chemotherapy may need to be delayed to allow these cells to recover.

2) Hemoglobin: is used to determine if someone is anemic. Anytime the hemoglobin is below 12 g/dL, the person is said to be anemic. Red blood cell transfusions, and sometimes iron can be given to restore the hemoglobin level, but anemia treatment should always aim at treating the underlying cause or condition.

3) Platelet count: is used to determine if the risk of bleeding is increased or if a platelet transfusion is required to prevent bleeding. Certain medications that increase bleeding risk, such as: aspirin, certain chemotherapy agents, and blood thinners, may need to be stopped temporarily until the platelet count is within a safe range.

What is a CMP?

A Comprehensive Metabolic Panel (CMP) is a frequently ordered blood test that tells clinicians the status of your: 1) Electrolytes & Acid/Base status2) Kidney function, 3) Liver function, 4) Blood sugar, and 5) Calcium at the time the test was taken. It is commonly used to monitor liver and kidney function when beginning new medications such as chemotherapy. A total of 14 tests are run simultaneously and are shown below.

Electrolytes & Acid/Base status:
1) Sodium, 2) Potassium, 3) Carbon dioxide, 4) Chloride

Kidney Function:
5) BUN (blood urea nitrogen), 6) Serum creatinine (Scr)

Liver Function:
7) AST, 8) ALT, 9) Total bilirubin, 10) Alk Phos, 11) Albumin, 12) Total protein

Blood sugar:
13) Serum glucose

14) Serum calcium

What is amylase?

Amylase is an enzyme that is produced by the pancreas that helps the body break down and digest carbohydrates. When the pancreas is injured, amylase is leaked out into the blood. 

Amylase, along with lipase, can be monitored to check for possible injury to the pancreas, indicated by elevated levels of the enzymes in the blood.

What is Lipase?

Lipase is an enzyme that is produced by the pancreas that helps the body break down fats. When the pancreas is injured, lipase is leaked out into the blood. Lipase, along with amylase, can be monitored to check for possible injury to the pancreas, indicated by elevated levels of the enzymes in the blood.

A note about side effect percentages

The number you see next to the percent sign (%) means how many people out of 100 are likely to experience this side effect.

For example, if the side effect is reported to occur in 8% of patients, this means that roughly 8 out of 100 people receiving this treatment will experience this side effect.