Atezolizumab
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | DRUG-ATEZOLIZUMAB |
|---|---|
| Тип | Препарат |
| Синоніми | TecentriqTecentriq Hybreza (SC)Атезолізумаб |
| Статус | переглянуто 2026-04-26 | очікує клінічного підпису |
| Хвороби | DIS-HCC DIS-NSCLC |
| Джерела | SRC-AASLD-HCC-2023 SRC-NCCN-HCC-2025 |
Дані про препарат
| Клас | Anti-PD-L1 humanized IgG1-kappa monoclonal antibody (immune checkpoint inhibitor) |
|---|---|
| Механізм дії | Humanized IgG1 monoclonal antibody (with engineered Fc that abrogates ADCC) binding programmed death-ligand 1 (PD-L1) on tumor cells and tumor-infiltrating immune cells. Blocks both PD-L1/PD-1 and PD-L1/B7-1 (CD80) interactions, restoring T-cell antitumor immunity. Anti-PD-L1 mechanism (vs anti-PD-1 of pembro/nivo) preserves PD-1/PD-L2 signaling — a theoretical lower autoimmune-toxicity profile, though clinical irAE spectrum is similar. Pivotal HCC role: atezolizumab + bevacizumab (IMbrave150) — first ICI combination to surpass sorafenib in 1L unresectable HCC. |
| Типове дозування | Standard: 1200 mg IV q3w OR 840 mg IV q2w OR 1680 mg IV q4w. HCC IMbrave150: atezolizumab 1200 mg + bevacizumab 15 mg/kg q3w until progression / unacceptable toxicity. NSCLC adjuvant (IMpower010, PD-L1 ≥1%): 1200 mg q3w × 16 cycles. SCLC IMpower133: 1200 mg q3w with carboplatin AUC 5 + etoposide 100 mg/m² × 4 cycles, then atezo q3w maintenance. Subcutaneous Tecentriq Hybreza (FDA 2024): 1875 mg SC q3w (with hyaluronidase co-formulation), ~7 min injection. |
| Зареєстровано в Україні | True |
| Відшкодовується НСЗУ | True |
| Остання перевірка для України | 2026-04-27 |
Нотатки
IMbrave150 prerequisites for HCC combo: Child-Pugh A, ECOG ≤1, EGD within 6 mo with treated high-risk varices (banding/ligation), no recent variceal bleed, no active GI bleeding, controlled BP, no significant proteinuria (UPCR <1 or 24-h urine <1 g). mOS 19.2 mo (vs 13.4 mo sorafenib). Major caveat: bevacizumab risks (perforation, hemorrhage, HTN, proteinuria) compound — strict patient selection. Standard ICI irAE management protocols apply (baseline TFTs / cortisol / LFTs / renal panel, serial labs, prompt steroids for Grade ≥2 irAE). IMpassion131 (TNBC paclitaxel combo) failed primary endpoint — TNBC indication withdrawn in US 2021; nab-paclitaxel combo (IMpassion130) still approved in some EU markets.
Де використовується
Contraindications
CI-PEMBROLIZUMAB-AUTOIMMUNE- CI-PEMBROLIZUMAB-AUTOIMMUNE
Regimens
REG-ATEZO-ADJUVANT-NSCLC- Atezolizumab adjuvant (resected NSCLC, 1 year)REG-ATEZO-BEV- Atezolizumab + BevacizumabREG-EP-ATEZO-SCLC- Etoposide-platinum + atezolizumab (extensive SCLC, 1L)