Tecentriq (atezolizumab) is a monoclonal antibody for the treatment of certain types of cancer. Marketed by Genentech, it has already been approved by the U.S. Food and Drug Administration (FDA) and the European Commission (EC) for the treatment of advanced urothelial carcinoma (including bladder cancer) and metastatic non-small cell lung cancer (NSCLC).

How Tecentriq works

The immune system is normally able to recognize abnormal cells such as cancer cells and kill them. In order to stop immune cells called T-cells from mistakenly attacking healthy cells, there is a system in place called immune checkpoints. One such checkpoint is the programmed cell death 1 (PD-1) pathway; T-cells have a receptor called PD-1 on their surface and healthy cells have a ligand or protein that binds to a specific receptor called PD-L1 that fits PD-1 on T-cells. The interaction between PD-L1 and PD-1 sends a signal to T-cells telling them to not attack the cells producing PD-L1.

Some cancer cells are able to produce PD-L1 and therefore avoid being detected and destroyed by T-cells. Tecentriq is a monoclonal antibody designed to bind to PD-L1, blocking its interactions with the PD-1 receptor. This enables T-cells to recognize cancer cells as abnormal and destroy them.

Tecentriq in clinical trials

The approval of Tecentriq as a monotherapy for the treatment of people with locally advanced or metastatic NSCLC was based on the results of a randomized Phase 2 clinical trial (NCT01903992) and a large randomized Phase 3 clinical trial (NCT02008227).

The Phase 2 trial showed that the median overall survival of patients treated with Tecentriq was 12.6 months while that of patients treated with docetaxel, a chemotherapy was 9.7 months.

Similarly, the Phase 3 trial showed that people treated with Tecentriq lived longer than those treated with docetaxel. (Median overall survival of 13.8 months with Tecentriq versus 9.6 months with docetaxel).

The approval of Tecentriq as a monotherapy for the treatment of people with locally advanced or metastatic urothelial carcinoma was based on the results of a randomized Phase 3 clinical trial (NCT02302807) showing that the median duration of response to treatment was 21.7 months in patients treated with Tecentriq compared to 7.4 months in patients treated with chemotherapy.

Other details

Tecentriq is given as an infusion into the bloodstream over a period of 60 minutes, every three weeks.

The most common side effects in people with urothelial carcinoma include tiredness, decreased appetite and nausea, constipation, urinary tract infection, diarrhea, and fever. The most common side effects in people with NSCLC include tiredness, decreased appetite, shortness of breath, cough, nausea, muscle or bone pain, and constipation.

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