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The subcutaneous injection of atezolizumab and hyaluronidase was evaluated in IMscin001 (NCT03735121), an open-label, multi-center, international, randomized trial in adults with locally advanced or metastatic non-small cell lung cancer who were not previously exposed to cancer immunotherapy and who had disease progression following treatment with platinum-based chemotherapy. [2]
Atezolizumab, sold under the brand name Tecentriq among others, is a monoclonal antibody medication used to treat urothelial carcinoma, non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), hepatocellular carcinoma and alveolar soft part sarcoma, [9] [11] but discontinued for use in triple-negative breast cancer (TNBC). [12]
Atezolizumab (Tecentriq) is a fully humanised IgG1 (immunoglobulin 1) antibody developed by Roche Genentech. In 2016, the FDA approved atezolizumab for urothelial carcinoma and non-small cell lung cancer. Avelumab (Bavencio) is a fully human IgG1 antibody developed by Merck Serono and Pfizer.
The first checkpoint antibody approved by the FDA was ipilimumab, approved in 2011 for treatment of melanoma. [2] It blocks the immune checkpoint molecule CTLA-4.Clinical trials have also shown some benefits of anti-CTLA-4 therapy on lung cancer or pancreatic cancer, specifically in combination with other drugs.
The most common side effects when used with other cancer medicines include peripheral neuropathy (nerve damage in the hands and feet), nausea, anemia (low red blood cell counts), neutropenia (low white blood cell counts), thrombocytopenia (low platelet counts), rash, tiredness, constipation, reduced appetite, diarrhea, and cough.
In 1983, Coates et al. found that people receiving chemotherapy ranked nausea and vomiting as the first and second most severe side-effects, respectively. [98] Up to 20% of people receiving highly emetogenic agents in this era postponed, or even refused potentially curative treatments. [ 99 ]
[52] [16] Atezolizumab for first-line treatment of metastatic NSCLC with PD-L1 ≥ 50% was approved recently by the FDA, [16] after the IMPOWER110 trial showed a median OS of 20.2 months for patients in the atezolizumab arm, compared with 13.1 months in the chemotherapy arm (p = 0.0106). [53]
Side effects of thalidomide-induced peripheral neuropathy include sensory symptoms, possible motor impairment, and gastrointestinal and cardiovascular autonomic manifestations. The symptoms of immunomodulatory drugs may dictate whether treatment is continued or discontinued, and they can last long-term after chemotherapy completion. [3]