Atezolizumab Clinical Trials
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Atezolizumab (Tecentriq) is an immunotherapy drug currently used to treat bladder, breast, and lung cancers.[1] At this time, it is only available to mesothelioma patients through clinical trials. If you are interested in getting involved in a trial with atezolizumab, talk to your specialists to determine if you qualify.
What Is Atezolizumab?
Atezolizumab is the generic name for a drug with the brand name Tecentriq®. It is an immunotherapy drug made by the biotech company Genentech. Atezolizumab was first approved by the U.S. Food and Drug Administration (FDA) to treat advanced and metastatic urothelial carcinoma, also known as bladder cancer.[2]
The FDA gave accelerated approval of the drug for special cases of bladder cancer. These include patients who cannot be given platinum-based chemotherapy drugs or who were given chemotherapy but experienced progression of the tumors.[2]
The FDA has granted full approval to atezolizumab for patients with non-small cell lung cancer in similar situations.[3] Those who see their disease progress after treatment with platinum chemotherapy drugs can be given atezolizumab. It’s given to patients with this type of lung cancer along with carboplatin, paclitaxel, and another immunotherapy drug, bevacizumab.
More recently, the FDA granted full approval for atezolizumab to be used as first-line treatment in extensive-stage small cell lung cancer and accelerated approval for use in triple-negative breast cancer with the PD-L1 receptor-positive.[4]
How Atezolizumab Works
Atezolizumab is an antibody that has been designed to target a specific protein on cancer cells. Immune system cells, known as T-cells, need to recognize the tumor cells and distinguish them from healthy cells.
Normal cells in the body have proteins on their surfaces known as immune checkpoints. When a T-cell binds to one of these, it recognizes it as normal and not a threat.
Cancer cells have evolved to trick the immune system into thinking they are normal healthy cells. They express checkpoint proteins that signal to the immune cells the same way healthy cells do.
Different types of tumors and individuals with cancer have cancer cells that may express different types of these checkpoint proteins.
Atezolizumab inhibits the interaction between immune T-cells and a specific checkpoint protein on cancer cells known as PD-L1. It works by binding to PD-L1 and preventing T-cells from binding there. In this way, the drug unmasks the cancer cells, and the immune system can recognize they are unhealthy and should be targets for destruction.[5]
Atezolizumab is specific to tumors whose cells express PD-L1. Some types of cancers express more of this protein than others, like bladder cancer.
Still, there are also individual differences, so one person may have cancer with more PD-L1 and may benefit from this treatment more than another. Some cancers have been shown to respond to this treatment even though they may not express any PD-L1.
Clinical Trials for Mesothelioma
Mesothelioma tumors often overexpress PD-L1, making it a good candidate for trials using atezolizumab. A couple of trials are currently recruiting mesothelioma patients:
- Atezolizumab Versus Placebo for the Adjuvant Treatment of Malignant Pleural Mesothelioma (Atezomeso) (AtezoMeso). This is a phase III study recruiting pleural mesothelioma patients who have undergone surgery for treatment.[6]
- BEAT-meso: Bevacizumab and Atezolizumab in Malignant Pleural Mesothelioma (BEAT-meso). This study is investigating the combination of two immunotherapy drugs along with chemotherapy.[7]
- Chemotherapy With or Without Immunotherapy for Peritoneal Mesothelioma. Investigators are not yet recruiting for this study, but they will need peritoneal mesothelioma pateints.[8]
Potential Side Effects
Immunotherapy drugs typically cause milder and fewer side effects than chemotherapy because they are more targeted, but they can still have undesirable consequences.
The most common side effects and adverse events of atezolizumab include:[2]
- Fatigue
- Constipation
- Nausea
- Loss of appetite
- Diarrhea
- Fever
- Uurinary tract infections
- Cough
- Difficulty breathing
Contact your doctor immediately if you have an unusual cough or diarrhea, as these side effects can quickly become dangerous.
Atezolizumab is not yet approved for treatment in patients with mesothelioma, but it is accessible through clinical trials. Researchers are hoping that it can help shrink tumors or slow the growth of cancer in mesothelioma. Results are not yet available, and trials are ongoing. To find out if you qualify for a clinical trial, talk to your medical team.
Page Medically Reviewed and Edited by Kyle J. Becker, PharmD, MBA, BCOP
Kyle J. Becker, PharmD is certified by the Board of Pharmacy Specialties in Oncology Pharmacy. Dr. Becker earned his pharmacy degree from Shenandoah University and he currently serves as an oncology pharmacist at Parkview Cancer Institute.