Managing select TECENTRIQ immune-related adverse events Managing select TECENTRIQ immune-related adverse events

ADVERSE REACTIONS (ARs) OCCURRING IN ≥10% OF TECENTRIQ® PATIENTS 1

TECENTRIQ Adverse Events Table TECENTRIQ Adverse Events Table

*Graded per National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.0.
Includes fatigue and asthenia.
Includes cough and exertional cough.
§Includes musculoskeletal pain, musculoskeletal stiffness, musculoskeletal chest pain, and myalgia.
Includes rash, erythematous rash, generalized rash, maculopapular rash, papular rash, pruritic rash, pustular rash, and pemphigoid.

  • The most common ARs (≥20%) were fatigue (43.5%), decreased appetite (23.5%), dyspnea (22%), and cough (26.4%)
  • ARs led to discontinuation of TECENTRIQ in 8% of patients and treatment interruption in 25% of patients
  • 1.6% of patients experienced fatal ARs; these included pneumonia, sepsis, septic shock, dyspnea, pulmonary hemorrhage, sudden death, myocardial ischemia, or renal failure
  • Serious ARs occurred in 33.5% of patients. The most frequent (>1%) were pneumonia, sepsis, dyspnea, pleural effusion, pulmonary embolism, pyrexia, and respiratory tract infection 

LABORATORY ABNORMALITIES WORSENING FROM BASELINE OCCURING IN ≥20% OF TECENTRIQ® PATIENTS 1*

TECENTRIQ Lab Abnormalities Table TECENTRIQ Lab Abnormalities Table

ALT=alanine aminotransferase; AST=aspartate aminotransferase; q3w=every 3 weeks.

*Each test incidence is based on the number of patients who had both baseline and at least one on-study laboratory measurement available: TECENTRIQ (range: 546−585) and docetaxel (range: 532−560).

IMPORTANT SAFETY INFORMATION AND INDICATION

Indication

TECENTRIQ is indicated for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) who have disease progression during or following platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving TECENTRIQ.

ALK=anaplastic lymphoma kinase; EGFR=epidermal growth factor receptor.

Serious Adverse Reactions
Please refer to the full Prescribing Information for important dose management information specific to adverse reactions.

Immune-Mediated Pneumonitis

  • Immune-mediated pneumonitis or interstitial lung disease, including fatal cases, have occurred with TECENTRIQ treatment
  • Across clinical trials, 2.5% of patients developed pneumonitis, including Grade 3 (0.6%), Grade 4 (0.1%), and Grade 5 (<0.1%) events 
  • Monitor patients for signs and symptoms of pneumonitis. Evaluate patients with suspected pneumonitis with radiographic imaging. Administer corticosteroids followed by a taper. Withhold TECENTRIQ for Grade 2 and permanently discontinue for Grade 3 or 4 pneumonitis

Immune-Mediated Hepatitis

  • Liver test abnormalities and immune-mediated hepatitis, including fatal cases, have occurred with TECENTRIQ treatment 
  • Across clinical trials, hepatitis occurred in 9% of patients, including Grade 3 (2.3%), Grade 4 (0.6%), and Grade 5 (<0.1%) events
  • Monitor patients for signs and symptoms of hepatitis, during and after discontinuation of TECENTRIQ, including clinical chemistry monitoring. Administer corticosteroids followed by a taper for immune-mediated hepatitis. Withhold TECENTRIQ for AST or ALT elevations more than 3 and up to 8 times the upper limit of normal or total bilirubin more than 1.5 and up to 3 times the upper limit of normal. Permanently discontinue TECENTRIQ for AST or ALT elevations more than 8 times the upper limit of normal or total bilirubin more than 3 times the upper limit of normal

Immune-Mediated Colitis

  • Immune-mediated colitis or diarrhea have occurred with TECENTRIQ treatment 
  • Across clinical trials, diarrhea or colitis occurred in 20% of patients, including Grade 3 (1.4%) events
  • Monitor patients for signs and symptoms of diarrhea or colitis. Withhold TECENTRIQ for Grade 2 or 3 and permanently discontinue for Grade 4 diarrhea or colitis

Immune-Mediated Endocrinopathies 

  • TECENTRIQ can cause immune-mediated endocrinopathies, including thyroid disorders, adrenal insufficiency, and type 1 diabetes mellitus, including diabetic ketoacidosis, and hypophysitis/hypopituitarism
  • Withhold TECENTRIQ for Grade 2 to 4 endocrinopathies
  • Thyroid Disorders
    • Across clinical studies, hypothyroidism occurred in 4.6% of patients and hyperthyroidism occurred in 1.6% of patients
    • Monitor thyroid function prior to and during treatment with TECENTRIQ. Initiate hormone replacement therapy or medical management of hyperthyroidism as clinically indicated
  • Adrenal Insufficiency
    • Across clinical studies, adrenal insufficiency occurred in 0.4% of patients, including Grade 3 (<0.1%) events
    • Monitor patients for clinical signs and symptoms of adrenal insufficiency. For Grade 2 to 4 adrenal insufficiency, initiate corticosteroids and hormone replacement therapy as clinically indicated
  • Type 1 Diabetes Mellitus
    • Across clinical studies, type 1 diabetes mellitus occurred in <0.1% of patients
    • Monitor patients for hyperglycemia or other signs and symptoms of diabetes. Initiate treatment with insulin as clinically indicated
  • Hypophysitis
    • Across clinical studies, Grade 2 hypophysitis occurred in <0.1% of patients
    • For Grade 2 to 4 hypophysitis, initiate corticosteroids and hormone replacement therapy as clinically indicated

Other Immune-Mediated Adverse Reactions

  • TECENTRIQ can cause severe and fatal immune-mediated adverse reactions. These immune-mediated reactions may involve any organ system 
  • Across clinical trials, cardiac, dermatologic, gastrointestinal, general, hematological, musculoskeletal, neurological, ophthalmological, renal, and vascular immune-mediated adverse reactions occurred at an incidence of <1% in patients who received TECENTRIQ or were reported for other products in this class of therapy
  • For suspected Grade 2 immune-mediated adverse reactions, exclude other causes and initiate corticosteroids as clinically indicated. For severe (Grade 3 or 4) adverse reactions, withhold TECENTRIQ and administer corticosteroids. Permanently discontinue TECENTRIQ for Grade 4 immune-mediated adverse reactions involving a major organ

Infections

  • TECENTRIQ can cause severe infections including fatal cases 
  • Across clinical trials, infections occurred in 42% of patients, including Grade 3 (8.7%), Grade 4 (1.5%), and Grade 5 (1%) events
  • Monitor patients for signs and symptoms of infection. For Grade 3 or 4 infections, withhold TECENTRIQ and resume once clinically stable

Infusion-Related Reactions

  • TECENTRIQ can cause severe or life-threatening infusion-related reactions
  • Across clinical trials, infusion-related reactions occurred in 1.3% of patients, including Grade 3 (0.2%) events
  • Monitor for signs and symptoms of infusion-related reactions. Interrupt or slow the rate of infusion in patients with Grade 1 or 2 infusion-related reactions. Permanently discontinue TECENTRIQ in patients with Grade 3 or 4 infusion-related reactions

Embryo-Fetal Toxicity

  • Based on its mechanism of action, TECENTRIQ can cause fetal harm when administered to a pregnant woman. Verify pregnancy status of females of reproductive potential prior to initiating TECENTRIQ. Advise females of reproductive potential of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with TECENTRIQ and for at least 5 months after the last dose 

Nursing Mothers/Fertility

  • Because of the potential for serious adverse reactions in breastfed infants from TECENTRIQ, advise female patients not to breastfeed while taking TECENTRIQ and for at least 5 months after the last dose
  • Based on animal studies, TECENTRIQ may impair fertility in females of reproductive potential while receiving treatment

Most Common Adverse Reactions
The most common adverse reactions in NSCLC (rate ≥20%) were fatigue (43.5%), decreased appetite (23.5%), dyspnea (22%), and cough (26.4%).

You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at 1-888-835-2555.

Please see full Prescribing Information for additional Important Safety Information.