Can you take Atezolizumab with Bleo 15k?

Atezolizumab has a major potential interaction with Adrenal Insufficiency.

Immune-related thyroid disorders, adrenal insufficiency, and type 1 diabetes mellitus, including diabetic ketoacidosis, have been reported in patients receiving atezolizumab. It is recommended to monitor patients for clinical signs and symptoms of endocrinopathies and to institute appropriate measures as necessary. Monitor as clinically indicated prior to and periodically during treatment and withhold, reduce dose, or discontinue therapy as necessary.

Atezolizumab has a moderate potential interaction with Autoimmune Disorders.

Programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibodies can cause immune-mediated adverse reactions, which may be severe or fatal. Immune-mediated adverse reactions can occur in any organ system or tissue at any time after starting therapy. This may be considered when using PD-1/PD-L1 blocking antibodies in patients with immune system disorders (e.g., ulcerative colitis, Crohn's disease, lupus) or with conditions affecting the nervous system (e.g., myasthenia gravis, Guillain-Barre syndrome). It is recommended to monitor patients closely for signs/symptoms that may be clinical manifestations of underlying immune-mediated adverse reactions.

Atezolizumab has a major potential interaction with Autoimmune Hepatitis.

Immune-mediated hepatitis occurred in patients receiving atezolizumab treatment with reported liver test abnormalities. Monitor patients for liver function test and for symptoms of hepatitis. Monitor bilirubin prior to and periodically during treatment. Therapy with atezolizumab should be administered cautiously in these patients. It is recommended to withhold atezolizumab for Grade 2 immune-mediated hepatitis and institute appropriate measures and to permanently discontinue therapy for Grade or 4 immune-mediated hepatitis

Atezolizumab has a major potential interaction with Autonomic Neuropathy.

Immune-related myasthenic syndrome/myasthenia gravis, Guillain-Barré, and ocular inflammatory toxicity have been reported with the use of atezolizumab therapy. Monitor patients for symptoms of motor and sensory neuropathy. Permanently discontinue therapy for any grade of myasthenic syndrome/myasthenia gravis or Guillain-Barré syndrome and institute medical intervention as appropriate.

Atezolizumab has a moderate potential interaction with Bone Marrow Transplantation.

Fatal and other serious complications can occur in patients who receive allogeneic hematopoietic stem cell transplantation (HSCT) before or after being treated with a programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibody. Transplant-related complications include hyperacute graft-versus-host disease (GVHD), acute GVHD, chronic GVHD, hepatic veno-occlusive disease after reduced intensity conditioning, and steroid-requiring febrile syndrome (without an identified infectious cause). These complications may occur despite intervening therapy between PD-1/PD-L1 blockade and allogeneic HSCT. It is recommended to follow patients closely for evidence of transplant-related complications and intervene promptly. The benefit versus risks of treatment with a PD-1/PD-L1 blocking antibody before or after an allogeneic HSCT should be considered.

Atezolizumab has a major potential interaction with Diabetes Mellitus.

Immune-related thyroid disorders, adrenal insufficiency, and type 1 diabetes mellitus, including diabetic ketoacidosis, have been reported in patients receiving atezolizumab. It is recommended to monitor patients for clinical signs and symptoms of endocrinopathies and to institute appropriate measures as necessary. Monitor as clinically indicated prior to and periodically during treatment and withhold, reduce dose, or discontinue therapy as necessary.

Atezolizumab has a major potential interaction with Encephalomyelitis, Acute Disseminated.

Immune-related meningoencephalitis has been reported with the use of atezolizumab therapy. Monitor patients for clinical signs and symptoms of meningitis or encephalitis. Permanently discontinue therapy for any grade of meningitis or encephalitis.

Atezolizumab has a major potential interaction with Guillain-Barre Syndrome.

Immune-related myasthenic syndrome/myasthenia gravis, Guillain-Barré, and ocular inflammatory toxicity have been reported with the use of atezolizumab therapy. Monitor patients for symptoms of motor and sensory neuropathy. Permanently discontinue therapy for any grade of myasthenic syndrome/myasthenia gravis or Guillain-Barré syndrome and institute medical intervention as appropriate.

Atezolizumab has a major potential interaction with Infection.

Severe infections, including urinary tract infections, pneumonia, sepsis, herpes encephalitis, and mycobacterial infection leading to retroperitoneal hemorrhage occurred in patients treated with atezolizumab. It is recommended to monitor patients for signs and symptoms of infection and to treat with antibiotics for suspected or confirmed bacterial infections. Withhold therapy for greater than or equal to Grade 3 infections.

Atezolizumab has a moderate potential interaction with Liver Disease.

Population pharmacokinetic analyses suggest that no dose adjustment of atezolizumab is needed for patients with mild hepatic impairment. No clinical studies were conducted with atezolizumab in patients with moderate or severe hepatic impairment. Caution is recommended when using this agent.

The bleomycin in Bleo 15k has a moderate potential interaction with Liver Disease.

The effect of hepatic insufficiency on the pharmacokinetics of bleomycin has not been evaluated. However, hepatic toxicity, beginning as a deterioration in liver function tests, has been reported. These toxicities may occur at any time after initiation of therapy. Caution and monitoring is advised if bleomycin is used in patients with liver impairment.

Atezolizumab has a major potential interaction with Myasthenia Gravis.

Immune-related myasthenic syndrome/myasthenia gravis, Guillain-Barré, and ocular inflammatory toxicity have been reported with the use of atezolizumab therapy. Monitor patients for symptoms of motor and sensory neuropathy. Permanently discontinue therapy for any grade of myasthenic syndrome/myasthenia gravis or Guillain-Barré syndrome and institute medical intervention as appropriate.

Atezolizumab has a moderate potential interaction with Noninfectious Colitis.

Immune-mediated colitis or diarrhea have been reported during atezolizumab therapy, in some cases with fatal outcomes. Monitor patients for signs and symptoms of diarrhea or colitis. It is recommended to withhold treatment with atezolizumab for Grade 2 diarrhea or colitis and if symptoms persist for longer than 5 days or recur, it is recommended to administer 1 to 2 mg/kg prednisone or equivalent per day. Withhold treatment for Grade 3 diarrhea or colitis and treat with IV methylprednisolone 1 to 2 mg/kg per day and convert to oral steroids once the patient has improved. For both Grade 2 and Grade 3 diarrhea or colitis, when symptoms improve to Grade 0 or Grade 1, taper steroids over greater than or equal to 1 month. Resume treatment if the event improves to Grade 0 or 1 within 12 weeks and corticosteroids have been reduced to the equivalent of less than or equal to 10 mg oral prednisone per day. Permanently discontinue atezolizumab for Grade 4 diarrhea or colitis.

Atezolizumab has a moderate potential interaction with Organ Transplant.

Solid organ transplant rejection and other transplant (including corneal graft) rejection have been reported with the use of programmed death receptor-1/ligand-1 (PD-1/PD-L1) blocking antibodies. This may be considered when using PD-1/PD-L1 blocking antibodies in patients who have received a solid organ or other transplant.

Atezolizumab has a major potential interaction with Pancreatitis.

Immune-related pancreatitis, including increases in serum amylase and lipase levels have been reported with the use of atezolizumab therapy. Caution is recommended and patients should be monitored for signs and symptoms of acute pancreatitis. Withhold atezolizumab for greater than or equal to Grade 3 serum amylase or lipase levels (> 2.0 ULN), or Grade 2 or 3 pancreatitis and permanently discontinue therapy for Grade 4 or any grade of recurrent pancreatitis.

The bleomycin in Bleo 15k has a major potential interaction with Pulmonary Impairment.

Pulmonary pneumonitis occurs in 10% of patients during bleomycin therapy and 1% progress to pulmonary fibrosis and death. Although pulmonary toxicity is age and dose related, occurring primarily in patients over 70 years of age and in those receiving a total dose > 400 units, it has occurred in younger patients at a lower dose. Extreme caution should be exercised when administering bleomycin in patients with compromised pulmonary function. Patients should be instructed to immediately report symptoms of dyspnea, cough, or congestion. Close clinical monitoring of pulmonary function is recommended.

Atezolizumab has a moderate potential interaction with Pulmonary Impairment.

Immune-mediated pneumonitis, sometimes fatal, or interstitial lung disease have been reported during atezolizumab therapy. Patients should be monitored with radiographic imaging and for symptoms of pneumonitis. Therapy with atezolizumab should be administered cautiously in patients with or predisposed to pulmonary dysfunction. It is recommended to withhold atezolizumab until resolution for Grade 2 pneumonitis and to permanently discontinue therapy for Grade 3 or 4 pneumonitis.

The bleomycin in Bleo 15k has a major potential interaction with Renal Dysfunction.

Bleomycin is primarily eliminated by the kidney. Approximately 60% to 70% of bleomycin is excreted in the urine as active drug. Moderate renal failure reduces elimination to < 20% of the drug. Extreme caution should be exercised when administering bleomycin in patients with existing or predisposition to significantly compromised renal function. Close clinical monitoring of renal function is recommended.

Atezolizumab has a moderate potential interaction with Renal Dysfunction.

Population pharmacokinetic analyses suggest that no dose adjustment of atezolizumab is required for patients with renal impairment. The effect of severe renal impairment on the pharmacokinetics of atezolizumab is unknown. Caution is recommended with these patients.

Atezolizumab has a major potential interaction with Thyroid Disease.

Immune-related thyroid disorders, adrenal insufficiency, and type 1 diabetes mellitus, including diabetic ketoacidosis, have been reported in patients receiving atezolizumab. It is recommended to monitor patients for clinical signs and symptoms of endocrinopathies and to institute appropriate measures as necessary. Monitor as clinically indicated prior to and periodically during treatment and withhold, reduce dose, or discontinue therapy as necessary.