Key clinical point: Atezolizumab (Tecentriq) is approved for use in the frontline treatment of adults with extensive-stage small cell lung cancer, when used in combination with carboplatin and etoposide.
Indications: The drug is indicated for the first-line treatment of adults with ES-SCLC.
Dosage and administration: The recommended dose is 1,200 mg IV over 60 minutes every 3 weeks. When administered on the same day as chemotherapy, atezolizumab should be given first.
Efficacy and safety: The FDA approval was based on the results of the phase 3 IMpower133 study involving 403 previously untreated patients with ES-SCLC. Patients were randomized to receive atezolizumab with carboplatin and etoposide or placebo with carboplatin and etoposide. Patients who received atezolizumab had significantly better overall survival at 12.3 months, compared with placebo at 10.3 months (hazard ratio, 0.70; 95% confidence interval, 0.54-0.91; P = .0069).
Side effects/risks: The most common adverse events associated with atezolizumab in the study were fatigue/asthenia, nausea, alopecia, constipation, and decreased appetite.