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Atezolizumab, sold under the brand name Tecentriq among others, is a monoclonal antibody medication used to treat urothelial carcinoma, non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), hepatocellular carcinoma and alveolar soft part sarcoma, but discontinued for use in triple-negative breast cancer (TNBC). It is a fully humanized, engineered monoclonal antibody of IgG1 isotype against the protein programmed cell death-ligand 1 (PD-L1).
Read the full article on WikipediaLocally advanced or metastatic non-small cell lung cancer Clinical criteria: Treatment Phase: Continuing treatment - 3 weekly treatment regimen Patient must have previously received PBS-subsidised treatment with this drug for this condition, AND The treatment must be the sole PBS-subsidised systemic anti-cancer therapy for this condition, AND Patient must have stable or responding disease.
Stage IV (metastatic) non-small cell lung cancer (NSCLC) Clinical criteria: Treatment Phase: Initial treatment 1 Treatment criteria: Patient must be undergoing combination treatment with bevacizumab and platinum-doublet chemotherapy. The condition must be non-squamous type non-small cell lung cancer (NSCLC), AND Patient must not have previously been treated for this condition in the metastatic setting; OR The condition must have progressed after treatment with a prior targeted therapy PBS-listed for this condition, AND Patient must not have received prior treatment with a programmed cell death-1 (PD-1) inhibitor or a programmed cell death ligand-1 (PD-L1) inhibitor for non-small cell lung cancer, AND Patient must have a WHO performance status of 0 or 1, AND The condition must not have evidence of an activating epidermal growth factor receptor (EGFR) gene mutation or an anaplastic lymphoma kinase (ALK) gene rearrangement in tumour material.
Extensive-stage small cell lung cancer Clinical criteria: Treatment Phase: Initial treatment The condition must be previously untreated, AND Patient must not have previously received programmed cell death-1/ligand-1 (PD-1/PD-L1) inhibitor therapy for any stage of small cell lung cancer, AND Patient must have a WHO performance status of 0 or 1, AND The treatment must be in combination with etoposide and a platinum-based antineoplastic drug.
Advanced (unresectable) Barcelona Clinic Liver Cancer Stage B or Stage C hepatocellular carcinoma Clinical criteria: Treatment Phase: Continuing treatment of hepatocellular carcinoma - 3 weekly treatment regimen Treatment criteria: Patient must be undergoing combination treatment with bevacizumab until disease progression, unless not tolerated. Patient must have previously received PBS-subsidised treatment with this drug for this condition, AND Patient must not have developed disease progression while being treated with this drug for this condition. PBS supply of this drug must be through only one of the two continuing treatment regimens at any given time
Resected early stage (Stage II to IIIA) non-small cell lung cancer (NSCLC) Clinical criteria: Treatment Phase: 1,680 mg administered once every 4 weeks, or 840 mg every 2 weeks Population criteria: Patient must be both: (i) initiating treatment, (ii) untreated with programmed cell death-1/ligand 1 (PD-1/PD-L1) inhibitor therapy; OR Patient must be continuing existing PBS-subsidised treatment with this drug; OR Patient must be both: (i) transitioning from existing non-PBS to PBS subsidised supply of this drug, (ii) untreated with programmed cell death-1/ligand 1 (PD-1/PD-L1) inhibitor therapy at the time this drug was initiated. Patient must have/have had a WHO performance status score of no greater than 1 at treatment initiation with this drug. AND The treatment must be for the purpose of adjuvant therapy following all of: (i) surgical resection, (ii) platinum-based chemotherapy, AND The condition must have/have had, at treatment commencement, an absence of each of the following gene abnormalities confirmed via tumour material sampling: (i) an activating epidermal growth factor receptor (EGFR) gene mutation, (ii) an anaplastic lymphoma kinase (ALK) gene rearrangement, AND The condition must have/have had, at treatment commencement, confirmation of programmed cell death ligand 1 (PD-L1) expression on at least 50% of tumour cells, AND The treatment must be the sole PBS-subsidised systemic anti-cancer therapy for this condition. Treatment criteria: Patient must be undergoing treatment that does not occur beyond the following, whichever comes first: (i) the first instance of disease progression/recurrence, (ii) 12 months in total for this condition from the first administered dose; mark any remaining repeat prescriptions with the words 'cancelled' where (i)/(ii) has occurred.
“Atezolizumab blocks the interaction of PD-L1 with programmed cell death protein 1 (PD-1) and CD80 receptors (B7-1Rs). 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.”
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