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Care During Chemotherapy and Beyond

Atezolizumab

(a te zoe LIZ ue mab)

Trade Name: Tecentriq™

Atezolizumab is the generic name for the trade drug name Tecentriq™. In some cases, health care professionals may use the generic name atezolizumab when referring to the trade drug name Tecentriq™.

Drug Type: Atezolizumab is an Anti-PD-L1 monoclonal antibody. (For more detail, see "How this drug works," below).

What Atezolizumab Is Used For:

For the treatment of patients with locally advanced or metastatic urothelial carcinoma who:

  • Have disease progression during or following platinum-containing chemotherapy.
  • Have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.

Note: If a drug has been approved for one use, physicians may elect to use this same drug for other problems if they believe it may be helpful.

How Atezolizumab Is Given:

  • Atezolizumab is given as an intravenous injection through a vein (IV) over 60 minutes for the first infusion, and if no infusion reaction, over 30 minutes for each infusion thereafter.
  • Treatment cycles are every 3 weeks (21 days)
  • You may receive medications before the infusion to reduce allergic reactions.

Side Effects:

Important things to remember about the side effects of atezolizumab:

  • Most people do not experience all of the side effects listed.
  • Observed side effects below may NOT be related to atezolizumab.
  • Side effects are often predictable in terms of their onset and duration.
  • Immune-related side effects can occur weeks or months after discontinuation of treatment.
  • There are many options to help manage and prevent worsening of side effects.
  • There is no relationship between the presence or severity of side effects and the effectiveness of the medication.

The following side effects have been observed commonly for patients taking atezolizumab but may NOT be related to atezolizumab:

These side effects have been observed less commonly of patients receiving atezolizumab but may NOT be related to atezolizumab:

*A rare but possible side effect of this class of drug is the trigger of an auto-immune reaction. This can happen at any time when taking this drug, and/or after stopping the drug. The immune system may go after normal cells in the body, e.g. lungs, skin, intestines, endocrine system, liver, pancreas, eyes, etc. Symptoms and signs of this reaction will be closely monitored throughout treatment (e.g. cough, shortness of breath, wheezing, rash, diarrhea/blood in stool, fatigue/weakness, visual changes, etc.). Lab work will also be used to check for elevated liver enzymes, kidney thyroid function, electrolytes, glucose, and blood counts.

Contact your health care provider right away if you have any new or worsening symptoms.

Not all potential side effects are listed above. Some of those that are more rare are not listed here. However, you should always inform your health care provider if you experience any unusual symptoms or changes.

When To Contact Your Doctor Or Health Care Provider:

Contact your health care provider immediately, day or night, if you should experience any of the following symptoms (may NOT be related to atezolizumab):

  • Fever of 100.4° (e.g. 38° C) or higher, chills, flank pain, cloudy or foul smelling urine, or other acute changes and/or signs of infection.
  • Signs of reaction to the drug (e.g. wheezing, chest tightness/pain, shortness of breath, cough, rash, itching, swelling of the face, lips, tongue, or throat)
  • Persistent or unusual headache, extreme generalized or focal weakness, dizziness/lightheadedness or fainting, stiff neck, new severe numbness, or vision changes.
  • Blood in stool, very dark stool, light colored stool, yellow skin/eyes/tongue, dark urine, unusual swelling of one of your legs/arms, bleeding, severe pain, or other acute changes.

The following symptoms require urgent medical attention, but might not usually be an emergency. Contact your doctor or health care provider within 24 hours of noticing any of the following (may NOT be related to atezolizumab):

  • Unable to eat or drink for 24 hours or have signs of dehydration, e.g. tiredness, thirst, dry mouth/skin, dark and decrease amount of urine, or dizziness
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication), decrease appetite
  • Vomiting (vomiting more than 4-5 times in a 24 hour period)
  • Diarrhea, abdominal or back pain, especially right side
  • Extreme fatigue that impairs your normal activities of daily living
  • Significant change in weight
  • Change in mood or personality, feeling confused
  • Constipation
  • Deeper voice, feeling cold or hair loss
  • Numbness or tingling in hands or feet, very bad muscle weakness
  • Bleed or bruise more easily than normal
  • Signs of infection: cough, frequent or painful urination, flu-like or other symptoms/signs

Always inform your health care provider if you experience any unusual symptoms or changes.

Precautions:

  • Before starting atezolizumab treatment, make sure you tell your doctor about any allergies, and other medications you are taking (including prescription, over-the-counter, vitamins, herbal remedies, etc.) and your complete past medical, surgical, family and social history
  • Do not receive any kind of immunization or vaccination without your doctor's approval while taking atezolizumab, e.g. it is OK to get inactivated/killed vaccines (flu vaccine), but not live vaccine (do not get flu-mist).
  • Inform your health care professional if you are pregnant or may be pregnant prior to starting this treatment. Atezolizumab may be hazardous to the fetus. Adverse events were observed in animal reproduction studies. Women who are pregnant or become pregnant must be advised of the potential hazard to the fetus.
  • For both men and women: Do not conceive a child (get pregnant) while taking atezolizumab. Barrier methods of contraception, such as condoms, are recommended during treatment. Women of child-bearing age should use effective contraception during therapy and for at least 5 months following treatment. Discuss with your doctor when you may safely become pregnant or conceive a child after therapy.
  • Do not breast feed while taking this medication. Due to the potential for serious adverse reactions in the nursing infant, breast-feeding is not recommended during therapy or for at least 5 months after the last dose.
  • If you have high blood sugar (diabetes), talk with your doctor. This drug might rarely raise blood sugar.
  • Inform your doctor before starting treatment, especially if you have any history of autoimmune disease (e.g. psoriasis, rheumatoid arthritis, lupus erythematosus, multiple sclerosis, or any other), inflammatory bowel disease (e.g. ulcerative colitis, Crohn's disease, etc.), interstitial pneumonitis (e.g. chronic lung inflammation), hepatitis B or C, HIV, if you are getting steroids or other medications that suppress your immune system, and your recent vaccinations.
  • If you go to any other health care provider or the Emergency Room, please let the provider know that you are taking this (or took it in the past) so they should take it into account for your management/plan of care.

Self-Care Tips (both general and related to atezolizumab):

  • Drink at least two to three quarts of fluid every 24 hours, unless you are instructed otherwise.
  • If you should experience nausea, take anti-nausea medications as prescribed by your doctor, and eat small frequent meals. Sucking on lozenges and chewing gum may also help.
  • Avoid sun exposure. Wear SPF 30 (or higher) sun block and protective clothing.
  • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely. You should discuss this with your doctor.
  • Use an electric razor to minimize bleeding.
  • Get plenty of rest.
  • Maintain good nutrition.
  • Wash your hands often.
  • You may be at risk for infection, report fever or any other signs of infection immediately to your healthcare provider. Try to avoid crowds or people with colds, and report fever or any other signs of infection immediately to your healthcare provider.
  • Discuss with your health care provider before taking any other medications including over the counter and herbal preparations.
  • If you experience symptoms or side effects, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.

Monitoring and Testing While Taking Atezolizumab:

You will be checked regularly by your health care professional while you are taking atezolizumab, to monitor side effects and check your response to therapy.

How Atezolizumab Works:

Atezolizumab is classified as a monoclonal antibody. Monoclonal antibodies are a relatively new type of "targeted" cancer therapy (against a specific "target").

Antibodies are an integral part of the body's immune system. Normally, the body creates antibodies in response to an antigen (such as a protein in a germ) that has entered the body.

The immune system utilizes activators/stimulators (accelerators) and checkpoints (breaks) to maintain the balance. One of those checkpoints is the interaction between two proteins, called PD-L1 and PD-1, that can cause suppression of the immune system and thus diminished attack against cancer cells. Both cancer cells and immune system cells can may over-express on their surface PD-L1, and this can reduce the attack of the immune system against cancer cells. Atezolizumab is a monoclonal antibody that attaches to PD-L1 and “blocks” its checkpoint function, thus ‘unleashing’ the brake on the immune system, to attack cancer cells

Note: We encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not at all a substitute for medical advice, and cannot cover all individual specific circumstances.

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