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Atezolizumab Dosage

Medically reviewed on May 5, 2017.

Applies to the following strengths: 1200 mg/20 mL

Usual Adult Dose for Non-Small Cell Lung Cancer

1200 mg IV over 60 minutes every 3 weeks until disease progression or unacceptable toxicity

Comments:
-If the first infusion is tolerated, all subsequent infusions may be delivered over 30 minutes.
-Do not administer this drug as an IV push or bolus.

Uses:
-Urothelial Carcinoma: For the treatment of patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin-containing chemotherapy and whose tumors express PD-L1 (PD-L1 stained tumor-infiltrating immune cells [IC] covering 5% or greater of the tumor area), OR are not eligible for any platinum-containing chemotherapy regardless of level of tumor PD-L1 expression, OR have disease progression during or following any platinum-containing chemotherapy, or within 12 months of neoadjuvant or adjuvant chemotherapy
-Metastatic Non-Small Cell Lung Cancer: For the treatment of patients with metastatic non-small cell lung cancer (NSCLC) who have disease progression 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 this drug

Usual Adult Dose for Urothelial Carcinoma

1200 mg IV over 60 minutes every 3 weeks until disease progression or unacceptable toxicity

Comments:
-If the first infusion is tolerated, all subsequent infusions may be delivered over 30 minutes.
-Do not administer this drug as an IV push or bolus.

Uses:
-Urothelial Carcinoma: For the treatment of patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin-containing chemotherapy and whose tumors express PD-L1 (PD-L1 stained tumor-infiltrating immune cells [IC] covering 5% or greater of the tumor area), OR are not eligible for any platinum-containing chemotherapy regardless of level of tumor PD-L1 expression, OR have disease progression during or following any platinum-containing chemotherapy, or within 12 months of neoadjuvant or adjuvant chemotherapy
-Metastatic Non-Small Cell Lung Cancer: For the treatment of patients with metastatic non-small cell lung cancer (NSCLC) who have disease progression 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 this drug

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Dose Modifications:
No dose reductions of this drug are recommended.

PNEUMONITIS:
-Grade 2: Withhold dose until Grade 1 or resolved and corticosteroid dose is less than or equal to prednisone 10 mg (or equivalent) per day.
-Grade 3 or 4: Permanently discontinue therapy.
HEPATITIS:
-AST or ALT more than 3 and up to 8 times the upper limit of normal (ULN) or total bilirubin more than 1.5 and up to 3 x ULN: Withhold dose until Grade 1 or resolved and corticosteroid dose is less than or equal to prednisone 10 mg (or equivalent) per day.
-AST or ALT more than 8 times the upper limit of normal or total bilirubin more than 3 times the upper limit of normal: Permanently discontinue therapy.
COLITIS/DIARRHEA:
-Grade 2 or 3: Withhold dose until Grade 1 or resolved and corticosteroid dose is less than or equal to prednisone 10 mg (or equivalent) per day.
-Grade 4: Permanently discontinue therapy.
ENDOCRINOPATHIES (including but not limited to hypophysitis, adrenal insufficiency, hyperthyroidism, and type 1 diabetes mellitus):
Grade 2, 3, or 4: Withhold dose until Grade 1 or resolved and clinically stable on hormone replacement therapy.
OTHER IMMUNE-MEDIATED ADVERSE REACTIONS INVOLVING A MAJOR ORGAN:
-Grade 3: Withhold dose until Grade 1 or resolved and corticosteroid dose is less than or equal to prednisone 10 mg (or equivalent) per day.
-Grade 4: Permanently discontinue therapy.
INFECTIONS:
-Grade 3 or 4: Withhold dose until Grade 1 or resolved.
INFUSION-RELATED REACTIONS:
-Grade 1 or 2: Interrupt or slow the rate of infusion.
-Grade 3 or 4: Permanently discontinue therapy.
PERSISTENT GRADE 2 OR 3 ADVERSE REACTION (excluding endocrinopathies):
-Grade 2 or 3 adverse reaction that does not recover to Grade 0 or 1 within 12 weeks after the last dose: Permanently discontinue therapy.
INABILITY TO TAPER CORTICOSTEROID:
-Inability to reduce to 10 mg (or equivalent) per day or less within 12 weeks after the last dose: Permanently discontinue therapy.
RECURRENT GRADE 3 OR 4 ADVERSE REACTION:
-Recurrent Grade 3 or 4 (severe or life-threatening) adverse reaction: Permanently discontinue therapy.

Precautions

CONTRAINDICATIONS:
-None

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Administer the initial infusion over 60 minutes through an IV line with or without a sterile, non-pyrogenic, low-protein binding in-line filter (pore size of 0.2 to 0.22 micron).
-If the first infusion is tolerated, all subsequent infusions may be delivered over 30 minutes.
-Do not coadminister other drugs through the same IV line.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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