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Anti-PD-L1 Monoclonal Antibody — Immune Checkpoint Inhibitor (Specialist Oncology Drug) Pregnancy: Atezolizumab should not be used during pregnancy unless the clinical condition of the woman requires treatment. Animal models indicate a potential risk of immune-mediated rejection of the foetus (foetal death), including increased rates of abortion or stillbirth; as an IgG1 it can cross the placental barrier. Women of childbearing potential must use effective contraception during and for 5 months after treatment. Breast-feeding: a risk to newborns/infants cannot be excluded; decide whether to discontinue breast-feeding or therapy.

Atezolizumab

Brand names: Tecentriq

Atezolizumab is an intravenous immune checkpoint inhibitor (a monoclonal antibody) used in oncology for cancers such as lung, bladder, breast and liver tumours.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 840 mg every two weeks, OR 1200 mg every three weeks, OR 1680 mg every four weeks
Route: Intravenous infusion
Frequency: Every 2 weeks (840 mg), every 3 weeks (1200 mg), or every 4 weeks (1680 mg), depending on schedule
Tecentriq must be initiated and supervised by physicians experienced in the treatment of cancer. The three dosing schedules (840 mg q2w, 1200 mg q3w, 1680 mg q4w) are used across licensed indications (urothelial carcinoma, non-small cell lung cancer, small cell lung cancer, triple-negative breast cancer, hepatocellular carcinoma) as monotherapy or in combination therapy. Treatment duration is indication-specific: e.g. until disease progression or unmanageable toxicity, until loss of clinical benefit, or for 1 year in early-stage/adjuvant NSCLC. Dose reductions are not recommended; management of immune-mediated adverse reactions is by dose delay or permanent discontinuation. In combination, Tecentriq should generally be administered first/prior to the combination partner when given on the same day. Patient selection may require PD-L1 testing for certain UC, TNBC or NSCLC indications.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to atezolizumab or to any of the excipients

Side effects

  • Fatigue (29.3%)
  • Decreased appetite (20.1%)
  • Rash (19.7%)
  • Nausea (18.8%)
  • Cough (18.2%); diarrhoea (18.1%); pyrexia (17.9%) (monotherapy pooled data)

Clinical monograph

How it works

It binds programmed death-ligand 1 (PD-L1) on tumour and immune cells, blocking its interaction with PD-1 and B7.1 and restoring T-cell-mediated antitumour immunity.

Prescribing in practice

  • It can cause immune-related adverse effects affecting almost any organ — including pneumonitis, colitis, hepatitis, endocrinopathies and skin reactions — which may be severe and require corticosteroids and treatment interruption.
  • Infusion-related reactions can occur and the infusion should be given with appropriate monitoring.
  • Endocrine effects such as thyroid dysfunction and rarer hypophysitis or adrenal insufficiency may present insidiously.

Monitoring

Monitor liver and thyroid function, glucose and clinical signs of immune-related toxicity before each cycle and as symptoms dictate.

Counselling the patient

  • Report new breathlessness, persistent diarrhoea, jaundice or marked fatigue promptly.
  • Carry an alert card and tell any treating clinician you are on immunotherapy.

Evidence & guidelines

Use is supported by randomised controlled trials and NICE technology appraisals across its licensed tumour indications.

Reference: NICE TAs (multiple — check specific tumour type); ESMO Immuno-Oncology Guidelines; ASCO/ESMO irAE management guidelines (2022); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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