Suvarna Garge (Editor)

Atezolizumab

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Type
  
Whole antibody

Target
  
PD-L1

AHFS/Drugs.com
  
tecentriq

Source
  
Humanized

Trade names
  
Tecentriq

Legal status
  
US: ℞-only

Atezolizumab imgmedscapecomthumbnaillibraryht160518tecen

Atezolizumab with erlotinib in combination treatment for egfr mutant nsclc


Atezolizumab (trade name Tecentriq) is a fully humanized, engineered monoclonal antibody of IgG1 isotype against the protein programmed cell death-ligand 1 (PD-L1). It is currently in clinical trials as an immunotherapy for several types of solid tumors. It is under investigation by Genentech/Roche.

Contents

In April 2016 Roche announced that atezolizumab had been granted fast track status for lung cancer by the FDA.

In May 2016 it was approved by the FDA for bladder cancer treatment.

Atezolizumab for platinum treated locally advanced or metastatic urothelial carcinoma


Medical uses

In May 2016 FDA granted accelerated approval to atezolizumab for locally advanced or metastatic urothelial carcinoma treatment after failure of cisplatin-based chemotherapy.

In October 2016, FDA approved atezolizumab for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) whose disease progressed during or following platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving atezolizumab.

Adverse effects

The most common adverse effects in studies were fatigue, decreased appetite, nausea, and infections. Urinary tract infection was the most common severe adverse effect.

Mechanism of action

Atezolizumab blocks the interaction of PD-L1 with programmed cell death protein 1 (PD-1) and CD80 (B7-1). PD-L1 can be highly expressed on certain tumors, which is thought to lead to reduced activation of immune cells (cytotoxic T-cells in particular) that might otherwise recognize and attack the cancer. Inhibition of PD-L1 by atezolizumab can remove this inhibitor effect and thereby engender an anti-tumor response. It is one of several ways to block inhibitory signals related to T-cell activation, a more general strategy known as "immune checkpoint inhibition."

For some cancers (notably bladder) the probability of benefit is related to PD-L1 expression, but most cancers with PD-L1 expression still do not respond, and many (about 15%) without PD-L1 expression do respond.

Research

As of 2016, it is currently in clinical trials for colorectal cancer, melanoma, breast cancer, non-small-cell lung carcinoma, bladder cancer, renal cell carcinoma.

Promising results have been observed for melanoma and non-small-cell lung cancer, and bladder cancer.

A phase 1 trial reported a 19% objective response rate in metastatic triple-negative breast cancer.

References

Atezolizumab Wikipedia


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