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How effective is atezolizumab (Tecentriq)?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Sep 24, 2020.

Official Answer

by Drugs.com

Key Points

Atezolizumab (brand name: Tecentriq) is approved to treat several different types of cancer. It’s effectiveness and your length of response will depend upon your diagnosis, previous treatments, and other medical conditions, among other factors. Cancer treatment is always individualized for each patient.

Your effectiveness and side effects with Tecentriq may not be the same as others who receive this medicine. Your doctor who is managing your cancer treatment regimen will always be the best health care professional to answer questions about your medicine, including effectiveness and side effects.

Tecentriq (atezolizumab), from Genentech, is approved by the FDA to treat:

  • advanced bladder cancer (urothelial carcinoma)
  • advanced melanoma (skin cancer)
  • metastatic non-small cell lung cancer (NSCLC)
  • metastatic triple-negative breast cancer (TNBC)
  • extensive stage small cell lung cancer (SCLC)
  • liver cancer (hepatocellular carcinoma)

Tecentriq targets the PD-1/PD-L1 pathway (proteins found on the body’s immune cells and some cancer cells). By blocking these interactions, Tecentriq may help the body’s immune system fight cancer cells by reactivating the T-cells.

Tecentriq is part of a group of immunotherapy drugs called Immune Checkpoint Inhibitors. These medicines have proven to be effective for many patients with various cancers, often extending a patient’s survival time or time without their disease worsening.

FDA Approval History: Atezolizumab (Tecentriq)

How effective is Tecentriq for cancer?

Tecentriq effectiveness for bladder cancer (urothelial carcinoma)

Tecentriq was first approved in May 2016 to treat advanced bladder and urinary tract (urothelial) cancer. Urothelial carcinoma also includes cancers of the urethra, ureters and renal pelvis. Two different treatment groups have been evaluated.

1. Patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following any platinum-containing chemotherapy, or within 12 months of treatment with a platinum-containing neoadjuvant (before surgery) or adjuvant (after surgery) chemotherapy regimen.

  • In the IMvigor210 study, the overall response rate (ORR) was 14.8% of 310 patients, with 5.5% of patients having a complete response (full tumor shrinkage) and 9.4% of patients having a partial response (partial tumor shrinkage). The median duration of these responses (DOR) was 27.7 months.
  • Overall response rate (ORR) is defined as the number of patients who have a partial or complete response to therapy
  • For patients who had high levels of PD-L1 expression, the ORR was 26% (95% CI: 17.7, 35.7) and the response lasted a median of 29.7 month.

2. Cisplatin-Ineligible Patients with Locally Advanced or Metastatic Urothelial Carcinoma

  • In April 2017, the use of Tecentriq for bladder cancer was expanded to include those who are not eligible for cisplatin chemotherapy, which may include up to 50% of patients.
  • In the IMvigor210 study, the overall response rate (ORR) was 23.5% of 119 patients, with 6.7% of patients having a complete response and 16.8% of patients having a partial response.
  • The median duration of response (DOR) ranged from 3.7 months to 16.6 months, but the final duration of response has not yet been reached.
  • For patients who had high levels of PD-L1 expression, the ORR was 28.1% (95% CI: 13.8, 46.8) and the response lasted a median of 29.7 months. The median duration of response (DOR) ranged from 8.1 months to 15.6 months, but the final duration of response has not yet been reached.

Tecentriq effectiveness for metastatic non-small cell lung cancer (NSCLC)

In December 2018, the FDA approved Tecentriq (atezolizumab) used in combination with Avastin (bevacizumab), paclitaxel and carboplatin (chemotherapy) for the initial treatment of patients with metastatic non-squamous non-small cell lung cancer (NSq NSCLC) with no EGFR or ALK genomic tumor aberrations.

  • In the Phase III study known as IMpower150, Tecentriq plus Avastin (bevacizumab) and chemotherapy helped patients live significantly longer compared to Avastin and chemotherapy (median overall survival of 19.2 versus 14.7 months).
  • Progression-free survival (the risk of disease worsening or death) was a median of 8.5 months for the group receiving Tecentriq plus Avastin (bevacizumab) and chemotherapy, and a median of 7 months compared to Avastin and chemotherapy treatment only.

Tecentriq is also approved to treat other patient groups with metastatic NSCLC. Speak with your doctor about further results with Tecentriq in patients with NSCLC.

Tecentriq effectiveness for triple-negative breast cancer

In March 2019, the FDA approved Tecentriq plus Abraxane (paclitaxel protein-bound) for the treatment of adults with unresectable or locally advanced or metastatic triple-negative breast cancer (TNBC) whose tumors express the protein PD-L1.

  • In the Phase 3 IMpassion130 study in patients with PD-L1 expression ≥ 1% who had not received prior chemotherapy for metastatic disease, Tecentriq plus Abraxane (paclitaxel protein-bound) significantly reduced the risk of disease worsening or death (known as progression-free survival, or PFS) by 40% compared with Abraxane plus placebo (median PFS=7.4 vs. 4.8 months; HR=0.60, 95% CI: 0.48-0.77, p<0.0001)
  • The median time of progression-free survival was 7.4 months with Tecentriq plus Abraxane compared to 4.8 months with Abraxane plus placebo (median PFS=7.4 vs. 4.8 months; HR=0.60, 95% CI: 0.48-0.77, p<0.0001).

Tecentriq effectiveness for small cell lung cancer

In March 2019, the FDA approved Tecentriq (atezolizumab) as a first-line agent to treat adults with extensive-stage small cell lung cancer (ES-SCLC). Tecentriq is used in combination with carboplatin and etoposide chemotherapy for this indication.

  • In clinical studies, Tecentriq was evaluated in 403 adults who had received no prior chemotherapy.
  • Median overall survival for those who took the Tecentriq combination was 12.3 months, compared to 10.3 months among those who took the chemotherapy drugs and a placebo.
  • The Tecentriq-based combination also significantly reduced the risk of disease worsening or death compared to chemotherapy alone (5.2 compared to 4.3 months).

Tecentriq effectiveness for advanced skin cancer (melanoma)

In July 2020, Tecentriq (atezolizumab) was approved to be used in combination with Cotellic (cobimetinib) and Zelboraf (vemurafenib) for the treatment of patients with BRAF V600 mutation-positive unresectable or metastatic melanoma. A BRAF gene mutation is found in some types of cancer, including melanoma. This mutation can increase the growth and spread of cancer cells.

  • In the Phase 3 clinical study IMspire150, the addition of Tecentriq to Cotellic and Zelboraf helped people live longer without their disease worsening or death (progression-free survival, PFS), compared to a placebo (inactive treatment) plus Cotellic and Zelboraf.
  • The median progression-free survival, the primary endpoint of the study, was 15.1 months in the group receiving Tecentriq plus Cotellic and Zelboraf. In the group receiving placebo plus Cotellic and Zelboraf the PFS was 10.6 months, a statistically significant difference (CI: 0.63-0.97; P=0.025).

Tecentriq effectiveness for liver cancer (hepatocellular carcinoma)

In May 2020, Tecentriq was approved to be used in combination with bevacizumab (Avastin) for the treatment of patients with liver cancer (hepatocellular carcinoma) that cannot be removed surgically or that has spread in the body. In addition, these patients have not received treatment for their liver cancer.

  • This regimen has been shown to improve a patient’s survival over sorafenib (Nexavar), the standard of care for first-line hepatocellular carcinoma.
  • Approval was based on the results of the Phase 3 IMbrave150 study. The study showed that Tecentriq in combination with Avastin significantly reduced the risk of death (known as overall survival, a primary endpoint) by 42% (hazard ratio [HR]=0.58; 95% CI: 0.42-0.79; p=0.0006) compared to sorafenib (Nexavar).
  • Tecentriq plus Avastin also significantly reduced the progression-free survival (PFS), which is the the risk of disease worsening or death, by 41% (HR=0.59; 95% CI: 0.47-0.76; p<0.0001), compared with sorafenib.
  • The median progression-free survival was 6.8 months for Tecentriq plus Avastin compared to 4.3 months with sorafenib (Nexavar).

Side effects can be serious and numerous with many cancer treatments, including Tecentriq (atezolizumab). Although Tecentriq is an immunotherapy and may be associated with less side effects than traditional chemotherapy, effects on normal cells can still occur.

See a full listing of Tecentriq serious and common side effects here. You should speak with your doctor about the side effects that may occur with any of the cancer treatments you receive, including Tecentriq.

Bottom Line

  • Atezolizumab (Tecentriq) is approved to treat several different types of cancer.
  • Cancer treatment is always individualized for each patient. It’s effectiveness and your length of response will depend upon your diagnosis, previous treatments, and other medical conditions, among other factors.
  • Your doctor who is managing your cancer treatment regimen will always be the best healthcare professional to answer questions about your medicine, including effectiveness and side effects.

This is not all the information you need to know about atezolizumab (Tecentriq) effectiveness for its various uses, or for its safe and effective use. Review the full Tecentriq information here, and discuss this information with your doctor or other health care provider.

References
  • Tecentriq (atezolizumab) [product information]. Genentech Inc. South San Francisco, CA. Accessed Sept. 23, 2020 at https://www.gene.com/download/pdf/tecentriq_prescribing.pdf
  • Tecentriq. FDA Approval History. Drugs.com. Accessed September 23, 2020 at https://www.drugs.com/history/tecentriq.html

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