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Home > UGI HEP Metastatic - aTEZOLIzumab and beVACizumab

UGI HEP Metastatic - aTEZOLIzumab and beVACizumab

Treatment Overview

If beVACizumab is discontinued, aTEZOLIzumab may be continued at 1680 mg on day 1 of a 28-day cycle.


This regimen contains a medicine where one or more biosimilars may exist. Any biosimilars used have been reviewed by the regulator (Medsafe) and relevant specialists were consulted nationally. Where regulators, in consultation with relevant specialists, have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably.

Cycle 1 (and all further cycles) - 21 days

Cycle length:
21

Cycle details

Cycle 1 (and all further cycles) - 21 days

Medication Dose Route Days Max Duration
aTEZOLIzumab 1200 mg intravenous 1 60 minutes
beVACizumab * 15 mg/kg intravenous 1 30 minutes

Full details

Cycle 1 (and all further cycles) - 21 days

Day: 1

Medication Dose Route Max duration Details
aTEZOLIzumab 1200 mg intravenous 60 minutes
Instructions:
  • If the initial dose is well tolerated, subsequent doses may be administered over 30 minutes.
  • Administer appropriate premedications if patient had a previous infusion related reaction of a grade where re-challenge is possible.
beVACizumab * 15 mg/kg intravenous 30 minutes
Instructions:
  • Blood pressure and urinalysis should be checked before each administration. If urine dipstick protein is less than or equal to 3+, proceed with infusion.
  • Initial dose may be administered over 30 minutes; if the previous dose is well tolerated, subsequent doses may also be administered over 30 minutes, or as per institutional practice.

Supportive Care Factors

Factor Value
Emetogenicity: Minimal
Hypersensitivity / Infusion related reaction risk: Low - routine premedication not recommended

References

Finn, R. S., S. Qin, M. Ikeda, et al. 2020. "Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma." N Engl J Med 382(20):1894-1905, PMID: 32402160

Galle, P.R., Finn, R. S., Qin S. et al. 2021. “Patient-reported outcomes with atezolizumab plus bevacizumab versus sorafenib in patients with unresectable hepatocellular carcinoma (IMbrave150): an open-label, randomised, phase 3 trial.” Lancet Oncol 22(5) https://doi.org/10.1016/S1470-2045(21)00151-0, PMID: 34051880

Morrissey, K. M., M. Marchand, H. Patel, et al. 2019. "Alternative dosing regimens for atezolizumab: an example of model-informed drug development in the postmarketing setting." Cancer Chemother Pharmacol 84(6):1257-1267., PMID: 31542806

Roche Products (New Zealand) Limited. Tecentriq New Zealand Data Sheet 06 August 2020. https://www.medsafe.govt.nz/profs/Datasheet/t/Tecentriqinf.pdf (Accessed 03 December 2020)

Roche Products (New Zealand) Limited. Avastin New Zealand Data Sheet 08 October 2020. https://www.medsafe.govt.nz/profs/Datasheet/a/Avastininf.pdf (Accessed 03 December 2020)

Tabernero J, Vyas M, Giuliani R, Arnold D, Cardoso F, Casali PG, Cervantes A, Eggermont AMM, Eniu A, Jassem J, Pentheroudakis G, Peters S, Rauh S, Zielinski CC, Stahel RA, Voest E, Douillard JY, McGregor K, Ciardiello F. Biosimilars: a position paper of the European Society for Medical Oncology, with particular reference to oncology prescribers. ESMO Open. 2017 Jan 16;1(6):e000142. doi: 10.1136/esmoopen-2016-000142. , PMID: 28848668

Lyman GH, Balaban E, Diaz M, Ferris A, Tsao A, Voest E, Zon R, Francisco M, Green S, Sherwood S, Harvey RD, Schilsky RL. American Society of Clinical Oncology Statement: Biosimilars in Oncology. J Clin Oncol. 2018 Apr 20;36(12):1260-1265. doi: 10.1200/JCO.2017.77.4893. Epub 2018 Feb 14., PMID: 29443651

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.