Atezolizumab Dosage

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:
-For the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy
-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:
-For the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy
-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

No adjustment recommended

Liver Dose Adjustments

Mild hepatic impairment: No adjustment recommended
Moderate to severe hepatic impairment: Data not available

Dose Adjustments

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

Withhold therapy for any of the following:
-Grade 2 pneumonitis
-Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) greater than 3 and up to 5 times upper limit of normal (ULN) or total bilirubin greater than 1.5 and up to 3 x ULN
-Grade 2 or 3 diarrhea or colitis
-Symptomatic hypophysitis, adrenal insufficiency, hypothyroidism, hyperthyroidism, or Grade 3 or 4 hyperglycemia
-Grade 2 ocular inflammatory toxicity
-Grade 2 or 3 pancreatitis, or Grade 3 or 4 increases in amylase or lipase levels (greater than 2 x ULN)
-Grade 3 or 4 infection
-Grade 2 infusion-related reactions
-Grade 3 rash

Therapy may be resumed in patients whose adverse reactions recover to Grade 0 or 1.

Permanently discontinue therapy for any of the following:
-Grade 3 or 4 pneumonitis
-AST or ALT greater than 5 x ULN or total bilirubin greater than 3 x ULN
-Grade 4 diarrhea or colitis
-Grade 4 hypophysitis
-Myasthenic syndrome/myasthenia gravis, Guillain-Barré or meningoencephalitis (all grades)
-Grade 3 or 4 ocular inflammatory toxicity
-Grade 4 or any grade of recurrent pancreatitis
-Grade 3 or 4 infusion-related reactions
-Grade 4 rash

Precautions

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 intravenous line.

Storage requirements:
-Consult the manufacturer product information.

Reconstitution/preparation techniques:
-Consult the manufacturer product information.

IV compatibility:
-Consult the manufacturer product information.