Summary

Commonly reported side effects of atezolizumab include: herpes simplex encephalitis, infection, mycobacterium infection, retroperitoneal hemorrhage, sepsis, severe infection, urinary tract infection, colitis, diarrhea, and increased thyroid stimulating hormone level. Continue reading for a comprehensive list of adverse effects.

Applies to atezolizumab: parenteral injection.

Side effects include:

Single-agent atezolizumab (≥20%): Fatigue or asthenia, nausea, cough, dyspnea, decreased appetite.

In combination with other antineoplastic agents in patients with NSCLC or SCLC (≥20%): Fatigue or asthenia, nausea, alopecia, constipation, diarrhea, decreased appetite.

In combination with albumin-bound paclitaxel in patients with triple-negative breast cancer (≥20%): Alopecia, peripheral neuropathy, fatigue, nausea, diarrhea, constipation, cough, headache, vomiting, decreased appetite; laboratory abnormalities occurring in ≥50% of patients include decreased concentrations of hemoglobin, leukocytes, neutrophils, and lymphocytes.

In combination with bevacizumab in patients with HCC (≥20%): Hypertension, fatigue, proteinuria.

In combination with cobimetinib and vemurafenib in patients with melanoma (≥20%): Rash, musculoskeletal pain, fatigue, hepatotoxicity, pyrexia, nausea, pruritus, edema, stomatitis, hypothyroidism, photosensitivity.

For Healthcare Professionals

Applies to atezolizumab: intravenous solution.

Cardiovascular

Common (1% to 10%): Venous thromboembolism^[Ref]

Dermatologic

Very common (10% or more): Rash (15%), pruritus (13%)^[Ref]

Endocrine

Frequency not reported: Immune-related thyroid disorders (e.g., hyperthyroidism, hypothyroidism)^[Ref]

Gastrointestinal

Very common (10% or more): Nausea (25%), constipation (21%), diarrhea (18%), abdominal pain (17%), vomiting (17%)

Common (1% to 10%): Dehydration, intestinal obstruction^[Ref]

General

The most common adverse reactions (greater than 20%) were fatigue, decreased appetite, nausea, urinary tract infection, pyrexia, and constipation. The most common Grade 3 to 4 adverse reactions (greater than 2%) were urinary tract infection, anemia, fatigue, dehydration, intestinal obstruction, urinary obstruction, hematuria, dyspnea, acute kidney injury, abdominal pain, venous thromboembolism, sepsis, and pneumonia.^[Ref]

Genitourinary

Very common (10% or more): Urinary tract infection (22%)

Common (1% to 10%): Urinary obstruction^[Ref]

Hematologic

Common (1% to 10%): Anemia, lymphopenia, increased alkaline phosphatase, increased alkaline phosphatase^[Ref]

Hepatic

Common (1% to 10%): Acute kidney injury, liver enzyme increase, increased ALT, increased AST

Immunologic

Very common (10% or more): Immune related colitis (19.7%)

Common (1% to 10%): Immune related pneumonitis, immune related hepatitis, sepsis

Frequency not reported: Immune related endocrinopathies^[Ref]

Local

Frequency not reported: Infusion related reactions^[Ref]

Metabolic

Very common (10% or more): Decreased appetite (26%)

Common (1% to 10%): Hyponatremia, hyperglycemia, hypoalbuminemia^[Ref]

Musculoskeletal

Very common (10% or more): Back/neck pain (15%), arthralgia (14%)^[Ref]

Nervous system

Frequency not reported: Meningoencephalitis, myasthenic syndrome/myasthenia gravis, Guillain-Barre^[Ref]

Ocular

Frequency not reported: Ocular inflammatory toxicity^[Ref]

Other

Very common (10% or more): Fatigue (52%), pyrexia (21%), peripheral edema (18%)

Common (1% to 10%): Increased creatinine^[Ref]

Psychiatric

Common (1% to 10%): Confusional state^[Ref]

Renal

Common (1% to 10%): Hematuria^[Ref]

Respiratory

Very common (10% or more): Dyspnea (16%), cough (14%)

Common (1% to 10%): Dyspnea, pneumonia^[Ref]