Atezolizumab (Tecentriq) for the treatment of advanced breast cancer

Introduction

Atezolizumab (trade name: Tecentriq) has been approved in Germany since August 2019 for the treatment of triple-negative breast cancer in women if it is metastatic or locally advanced and can’t be surgically removed. This medication is combined with nab-paclitaxel and is considered as a treatment option if the cancer has a certain amount of cells with the programmed death ligand 1 (at least 1%) and the patient has not yet had any chemotherapy.

The breast cancer is surgically removed, if possible. But sometimes the tumor has already become too large or the cancer has spread to other parts of the body (metastasis). It is then called advanced breast cancer.

The growth of tumor cells in breast cancer is influenced by various factors. Some breast cancer cells have certain receptors, for example for the estrogen and progesterone, or for the human epidermal growth factor HER2. Breast cancer that doesn't have many of these kinds of receptors is called triple-negative breast cancer. Triple-negative breast cancer is more aggressive than other types of breast cancer.

Some women have breast cancer cells that have the protein PD-L1 (programmed death ligand 1). PD-L1 stops the body’s from being able to fight the cancer cells effectively.

Atezolizumab binds to PD-L1, and is believed to activate the .

Application

Atezolizumab is given as an infusion (drip) in 28-day treatment cycles. The recommended dose is 840 mg of atezolizumab. It is used two times per cycle (every two weeks).

Nab-paclitaxel is used three times per cycle.

The treatment is stopped if the cancer continues to grow or if the side effects become too severe.

Other treatments

The standard treatment for triple-negative advanced breast cancer is chemotherapy with an anthracycline and/or a taxane.

Assessment

In 2019, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) wanted to look into whether atezolizumab has any advantages or disadvantages for the treatment of breast cancer for which it is approved when compared with the standard treatments.

But the manufacturer didn’t provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of atezolizumab (Tecentriq).

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Atezolizumab (breast cancer)  – Benefit assessment according to §35a Social Code Book V. Dossier assessment; Commission A19-81. December 20, 2019. (IQWiG reports; Volume 860).

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on January 30, 2020
Next planned update: 2023

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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