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Tecentriq Hybreza (atezolizumab/ hyaluronidase-tqjs)
atezolizumab/ hyaluronidase
Adult Dosing .
Dosage forms: INJ
Special Note
- [drug name clarification]
- Info: nonproprietary name = atezolizumab/hyaluronidase-tqjs
- [equivalency or interchangeability info]
- Info: not interchangeable with IV atezolizumab; do not substitute on a mg to mg basis
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing including toxicity-related dose adjustments
non-small cell lung CA
- [stage II-IIIA PD-L1-expressing disease, adjuvant tx]
- Dose: 1875 mg/30,000 units SC q3wk for up to 1y; Start: after resection and platinum-based chemo
- [metastatic high PD-L1-expressing disease, first-line tx]
- Dose: 1875 mg/30,000 units SC q3wk; Info: for patients with no EGFR or ALK genomic tumor aberrations
- [metastatic nonsquamous disease, first-line tx]
- Dose: 1875 mg/30,000 units SC q3wk; Info: for patients with no EGFR or ALK genomic tumor aberrations; part of multi-drug chemo regimen
- [metastatic progressive disease]
- Dose: 1875 mg/30,000 units SC q3wk; Info: for patients with disease progression on or after platinum-containing chemo
small cell lung CA, extensive-stage
- [first-line induction tx]
- Dose: 1875 mg/30,000 units SC q3wk; Info: part of multi-drug chemo regimen
- [maintenance tx]
- Dose: 1875 mg/30,000 units SC q3wk; Info: for patients without disease progression after first-line induction tx; use with lurbinectedin
hepatocellular CA, unresectable or metastatic
- [1875 mg/30,000 units SC q3wk]
- Info: use with bevacizumab
melanoma, unresectable or metastatic
- [1875 mg/30,000 units SC q3wk]
- Start: after one 28-day cycle of cobimetinib and vemurafenib; Info: for patients with BRAF V600 mutation; use with cobimetinib and vemurafenib
alveolar soft part sarcoma, unresectable or metastatic
- [1875 mg/30,000 units SC q3wk]
renal dosing
- [see below]
- eGFR >30: no adjustment; eGFR <30: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- bilirubin 1.1-3x ULN or AST >ULN: no adjustment; bilirubin >3x ULN: not defined
Peds Dosing .
- Dosage forms: INJ
Special Note
- [drug name clarification]
- Info: nonproprietary name = atezolizumab/hyaluronidase-tqjs
- [equivalency or interchangeability info]
- Info: not interchangeable with IV atezolizumab; do not substitute on a mg to mg basis
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing including toxicity-related dose adjustments
alveolar soft part sarcoma, unresectable or metastatic
- [12 yo and older, >40 kg]
- Dose: 1875 mg/30,000 units SC q3wk
renal dosing
- [see below]
- eGFR >30: no adjustment; eGFR <30: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- bilirubin 1.1-3x ULN or AST >ULN: no adjustment; bilirubin >3x ULN: not defined
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- avoid: breastfeeding during tx and x5mo after D/C
- caution: patients of childbearing potential
- caution: transplant history
- caution: transplant candidates
- caution: thoracic XRT history
Drug Interactions .
Overview
atezolizumab
PD-L1 blocking antibody
- immunomodulatory effects
hyaluronidase
dispersion agent
-
None
Contraindicated
- adenovirus vaccine, live
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine, live
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Monitor/Modify Tx
- anthrax vaccine
- chikungunya vaccine
- COVID-19 vaccine
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- ebola vaccine, live
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- influenza H5N1 vaccine
- influenza vaccine
- Japanese encephalitis vaccine
- meningococcal vaccine
- pneumococcal vaccine
- poliovirus vaccine
- rabies vaccine
- respiratory syncytial virus vaccine
- smallpox/mpox vaccine, live
- tick-borne encephalitis vaccine
- typhoid vaccine
Adverse Reactions .
Serious Reactions
- immune-mediated reaction
- pneumonitis
- interstitial lung disease
- pleural effusion
- dyspnea
- pulmonary embolism
- hepatitis
- colitis
- endocrinopathy
- adrenal insufficiency
- hypophysitis
- thyroiditis
- hypothyroidism
- hyperthyroidism
- hypoparathyroidism
- diabetes mellitus, type 1
- hypopituitarism
- pancreatitis
- nephritis
- meningitis
- encephalitis
- demyelination
- myasthenia gravis
- Guillain-Barre syndrome
- nerve paresis
- autoimmune neuropathy
- tenosynovitis
- myositis
- rhabdomyolysis
- myocarditis
- pericarditis
- pericardial effusion
- cardiac tamponade
- arrhythmia
- vasculitis
- uveitis
- Vogt-Koyanagi-Harada-like syndrome
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- drug reaction with eosinophilia and systemic symptoms
- hemolytic anemia
- aplastic anemia
- hemophagocytic lymphohistiocytosis
- immune thrombocytopenic purpura
- hemorrhage
- infection, severe
- sepsis
- infusion reaction, severe
- anaphylaxis
Common Reactions
- fatigue
- cough
- fever
- appetite decr.
- dyspnea
- rash
- nausea
- constipation
- diarrhea
- pain
- arthralgia
- pruritus
- hypothyroidism
- peripheral neuropathy
- pneumonitis
- hepatitis
- anemia
- injection site reaction
- ALT or AST incr.
- hypoalbuminemia
- hyponatremia
- alk phos incr.
- Cr incr.
- lymphopenia
Safety/Monitoring .
Monitoring Parameters
pregnancy test at baseline; Cr, LFTs, TFTs at baseline, then periodically; glucose; signs/symptoms of infusion reaction
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; risk of embryo-fetal toxicity, including spontaneous abortion and stillbirth, based on animal data with other PD-1/PD-L1 pathway inhibitors and drug's mechanism of action
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and x5mo after D/C in patients of childbearing potential
Lactation
Clinical Summary
avoid breastfeeding during tx and x5mo after D/C; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: for atezolizumab: catabolism; CYP450: unknown; for hyaluronidase: local; CYP450: unknown
Excretion: for atezolizumab: other; Half-life: 27 days; for hyaluronidase: unknown; Half-life: 0.5 days; Info: permeability of tissue restored within 24-48h
Subclass: Immunotherapy, Immune Checkpoint Inhibitors ; Immunotherapy, PD-1/PD-L1 Inhibitors
Mechanism of Action
for atezolizumab: binds to PD-L1 on tumor cells and tumor-infiltrating immune cells, blocking PD-1/PD-L1 pathway-mediated inhibition of anti-tumor immune response, resulting in decreased tumor growth; for hyaluronidase: incr. subcutaneous tissue permeability by temporarily depolymerizing hyaluronan, leading to incr. absorption of atezolizumab
Formulary .
No Formulary Selected
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