Tecentriq
Tecentriq (atezolizumab) is an immunotherapy medication that’s used to treat several different types of cancer, like lung cancer, liver cancer, and melanoma. It turns on your immune system to fight cancer. But this can sometimes cause side effects like rash, diarrhea, and lung problems that might need temporary treatment with corticosteroids. Tecentriq (atezolizumab) is given through the vein (intravenously, IV) at an infusion center or provider’s office.
What is Tecentriq (atezolizumab)?
What is Tecentriq (atezolizumab) used for?
Non-small cell lung cancer (NSCLC)
Early-stage cancer that’s had surgery and chemotherapy, given by itself
Cancer that has spread (metastatic), given by itself or with chemotherapy
Advanced small cell lung cancer (SCLC), given with chemotherapy
Certain liver cancers that can’t be surgically removed or has spread, given with Avastin (bevacizumab)
Advanced melanoma in people with a specific mutation, given with other targeted therapy
Advanced alveolar soft part sarcoma (ASPS)
How Tecentriq (atezolizumab) works
Your immune system plays an important role in our body, for example, to fight infections. The immune system also attacks and kills cancer cells that it recognizes as abnormal. Some cancer cells can hide from the immune system by using the programmed death-1 (PD-1) pathway. When a cancer cell uses the PD-1 pathway, it stops our immune cells from attacking the cancer cells. This allows the cancer to grow.
Tecentriq (atezolizumab) is an immunotherapy medication known as a PD-L1 inhibitor. It blocks the PD-1 pathway, which helps the immune system recognize and attack cancer cells. As a result, the immune system can kill the cancer cells and stop the cancer from growing.
Drug Facts
What are the side effects of Tecentriq (atezolizumab)?
Common Side Effects
- Low red blood cells (anemia; up to 69%)
- Other abnormal lab test results (up to 48%)
- Low white blood cells (up to 49%)
- Tiredness (up to 44%)
- Higher liver enzyme levels in blood (up to 38%)
- Cough (up to 26%)
- Lower appetite (up to 23%)
- Trouble breathing (up to 22%)
- Muscle pain (up to 20%)
- Nausea (up to 18%)
Other Side Effects
- Rash
- Fever
- Nausea
- Diarrhea
- Constipation
- Joint pain
- Numbness and tingling in fingers and toes
Serious Side Effects
- Serious immune-related side effects: rash, diarrhea, trouble breathing, chest pain, severe stomach pain, mucus or blood in stool
- Serious reaction during infusion: itching, trouble breathing, fast heart beat, feeling warm or hot
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your doctor or health care professional as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dry cough, shortness of breath or trouble breathing
- Eye pain, redness, irritation, or discharge with blurry or decreased vision
- Heart muscle inflammation—unusual weakness or fatigue, shortness of breath, chest pain, fast or irregular heartbeat, dizziness, swelling of the ankles, feet, or hands
- Hormone gland problems—headache, sensitivity to light, unusual weakness or fatigue, dizziness, fast or irregular heartbeat, increased sensitivity to cold or heat, excessive sweating, constipation, hair loss, increased thirst or amount of urine, tremors or shaking, irritability
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
- Kidney injury (glomerulonephritis)—decrease in the amount of urine, red or dark brown urine, foamy or bubbly urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pain, tingling, or numbness in the hands or feet, muscle weakness, change in vision, confusion or trouble speaking, loss of balance or coordination, trouble walking, seizures
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
- Bone, joint, or muscle pain
- Diarrhea
- Fatigue
- Loss of appetite
- Nausea
- Skin rash
Pros and cons of Tecentriq (atezolizumab)
Pros
Doesn’t cause side effects, like nausea, vomiting, and hair loss, that are common with traditional chemotherapy
First-choice treatment option for certain small-cell and non-small-cell lung and liver cancers
Uses your body’s own immune system to fight cancer
Cons
Might cause immune-related side effects like diarrhea, rash, and lung problems
Might require treatment breaks and a corticosteroid to manage side effects
Given through an IV, which requires using a needle
Pharmacist tips for Tecentriq (atezolizumab)
Contact your provider right away if you experience any immune-related side effects, like diarrhea, skin rash, or trouble breathing, at any time during your Tecentriq (atezolizumab) treatment. These reactions could be signs that your immune system has become too active from Tecentriq (atezolizumab) treatment. You might need additional medical attention for these side effects.
Don’t use over-the-counter medications to treat any side effects you might have while you’re taking Tecentriq (atezolizumab) without first contacting your provider. Side effects from the medication typically need to be treated with a corticosteroid such as prednisone. Medications that you might normally use, like loperamide (Imodium-AD) for diarrhea, won’t work as well to help with some side effects.
If you need to take a steroid for a few weeks to help with side effects, don’t stop taking the steroid medication suddenly because this can cause uncomfortable symptoms. When it’s time to stop the steroid medication, your provider will give you instructions to do so slowly and safely. This is called tapering.
Make sure to get your lab work done on time while you’re taking Tecentriq (atezolizumab). The lab results help your provider check for possible side effects that don’t typically cause symptoms, such as liver, thyroid, or kidney problems.
Most times, having immune-related side effects will mean that you’ll need to take a break from Tecentriq (atezolizumab) to help treat these side effects. If you start having thyroid problems though, you might be able to take thyroid medications to manage this problem while you continue treatment with Tecentriq (atezolizumab).
If you feel warm, itchy, chest tightness, or have trouble breathing during your Tecentriq (atezolizumab) infusion, tell your nurse right away. These can be signs of an infusion reaction that your nurse can help treat.
If you’re able to become pregnant, use birth control while you’re taking Tecentriq (atezolizumab) and for at least 5 months after the last dose. Let your provider know if you become pregnant during or after treatment. Tecentriq (atezolizumab) can cause harm to an unborn baby.
Frequently asked questions about Tecentriq (atezolizumab)
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What are the risks and warnings for Tecentriq (atezolizumab)?
Tecentriq (atezolizumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Immune-related side effects
Side effects from immunotherapy like Tecentriq (atezolizumab) are typically called immune-related adverse events (irAEs). They happen when the immune system becomes too active and doesn’t just attack cancer cells; it attacks healthy cells, too. These side effects can happen anywhere in your body. They can be mild or very serious. And they can happen at any time during treatment.
You might notice certain immune-related side effects, like diarrhea, skin rash, or shortness of breath. Call your provider right away if you experience any of these symptoms. You might need to pause or stop Tecentriq (atezolizumab) and take a corticosteroid depending on how severe your symptoms are. Other side effects, like changes in lab values that show how well your liver and kidneys are working, might not cause noticeable symptoms. You’ll need blood tests done often so your provider can monitor for those side effects closely.
Infusion reactions
Some people taking Tecentriq (atezolizumab) have experienced reactions during their infusion. If you feel itchy or warm, have trouble breathing, feel nauseous, or suddenly have a fast heart rate while receiving Tecentriq (atezolizumab), let your nurse know right away. Most of the time, giving the infusion slower can help. But sometimes, having a serious reaction means that you shouldn’t take Tecentriq (atezolizumab) again to avoid having another reaction in the future.
Stem cell transplant complications
Risk factors: People who’ve received a stem cell (bone marrow) transplant
Some people who’ve taken immunotherapy medications like Tecentriq (atezolizumab) and who’ve also had a stem cell transplant have experienced serious problems like graft-versus-host-disease. Let your provider know if you’ve had a stem cell transplant before taking Tecentriq (atezolizumab). Also notify your provider if you’re planning to have a stem cell transplant after treatment with Tecentriq (atezolizumab). Your provider will follow up with you closely for signs and symptoms of these problems.
Harm to unborn baby
Risk factors: Women who are pregnant
Based on animal studies, Tecentriq (atezolizumab) might harm an unborn baby or raise the risk for miscarriage (pregnancy loss) when taken during pregnancy. Because of these risks, if you’re able to get pregnant, you should use birth control while taking Tecentriq (atezolizumab) and for at least 5 months after the last dose. Let your provider know right away if you become pregnant while taking Tecentriq (atezolizumab).
Tecentriq (atezolizumab) dosage forms
Typical dosing for Tecentriq (atezolizumab)
This medication is given as an injection into the vein (IV) by a healthcare provider.
Adults: For most cancers, there are a few dosing options your healthcare team will decide to use for your Tecentriq (atezolizumab) treatment. Dosing options include 840 mg given every 2 weeks; 1,200 mg given every 3 weeks; or 1,680 mg given every 4 weeks. Which option your provider chooses will depend on your specific cancer diagnosis and whether you’re taking Tecentriq (atezolizumab) with other anticancer medications.
Children 2 years and older (ASPS only): The dose is based on your child’s body weight. The typical dose is 15 mg/kg given every 3 weeks. Each dose can be up to a maximum of 1,200 mg.
What are alternatives to Tecentriq (atezolizumab)?
Non-small cell lung cancer (NSCLC)
Early-stage cancer that’s had surgery and chemotherapy, given by itself
Cancer that has spread (metastatic), given by itself or with chemotherapy
Advanced small cell lung cancer (SCLC), given with chemotherapy
Certain liver cancers that can’t be surgically removed or has spread, given with Avastin (bevacizumab)
Advanced melanoma in people with a specific mutation, given with other targeted therapy
Advanced alveolar soft part sarcoma (ASPS)
Non-small cell lung cancer (NSCLC)
Renal cell carcinoma (kidney cancer)
Endometrial carcinoma (uterine cancer)
Cancers with high tumor mutation burden (TMB-H), high microsatellite instability (MSI-H), or deficient mismatch repair (dMMR)
Certain skin cancers
Certain non-small cell lung cancers that have spread
What is the latest news about Tecentriq (atezolizumab)?
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References
Best studies we foundAmerican Cancer Society. (n.d.). Stem cell or bone marrow transplant.
American Cancer Society. (2020). What are infusion or immune reactions?
Asafo-Agyei, K. O., et al. (2023). Hepatocellular carcinoma. StatPearls.
Conroy, M., et al. (2022). Immune-related adverse events and the balancing act of immunotherapy. Nature Communications.
Genentech, Inc. (2023). Tecentriq- atezolizumab injection, solution [package insert]. DailyMed.
Han, Y., et al. (2020). PD-1/PD-L1 pathway: Current researches in cancer. American Journal of Cancer Research.
Hodgens, A., et al. (2023). Corticosteroids. StatPearls.
InformedHealth.org. (2020). How does the immune system work? Institute for Quality and Efficiency in Health Care
National Cancer Institute. (2019). Alveolar soft part sarcoma (ASPS).
National Cancer Institute. (2023). Nausea and vomiting related to cancer treatment (PDQ®)–Health professional version.
National Cancer Institute. (2023). Non-small cell lung cancer treatment (PDQ®)–Patient version.
National Cancer Institute. (2023). Small cell lung cancer treatment (PDQ®)–Patient version.
National Comprehensive Cancer Network. (2022). Immunotherapy side effects: Immune checkpoint inhibitors.
National Comprehensive Cancer Network. (2022). Small cell lung cancer.
National Comprehensive Cancer Network. (2022). Understanding immunotherapy side effects.
National Comprehensive Cancer Network. (2023). Early and locally advanced non-small cell lung cancer.
National Comprehensive Cancer Network. (2023). Liver cancer.
National Comprehensive Cancer Network. (2023). Melanoma.
National Marrow Donor Program. (n.d.). Graft-versus-host disease basics.
National Marrow Donor Program. (n.d.). GVHD signs and symptoms.
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