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Liver cancer (hepatocellular carcinoma)

Tecentriq® (atezolizumab) in combination with Avastin® (bevacizumab)

Tecentriq is used to treat hepatocellular carcinoma (HCC) which is the most common form of liver cancer. Tecentriq is used together with a medicine called Avastin when the HCC is unable to be removed by surgery or has spread to other parts of the body. 

Tecentriq

Pronounced Tee-sen-trick

How Tecentriq works

Tecentriq belongs to a group of medicines called immunotherapies, which work with your body’s own immune system to fight cancer cells. Tecentriq is not the same as chemotherapy.

Tecentriq works by attaching to a protein in your body, called PD-L1, which is found on some tumour cells. When this happens Tecentriq helps the immune system to better identify the cancer cells and kill them.

Avastin

Pronounced A-vas-tin

How Avastin works

Avastin works by blocking an important growth factor called vascular endothelial growth factor or VEGF. This disrupts blood flow to the cancer, restricting the supply of nutrients that it needs to grow and spread.

Because Tecentriq and Avastin work in different ways, the two medicines complement each other when they are used to treat HCC.

How Tecentriq and Avastin are administered

Tecentriq, together with Avastin, is given by a drip or intravenous infusion that your doctor or nurse inserts into a vein. Alternatively, Tecentriq may be administered by subcutaneous injection. The number of infusions you will be given depends on how you respond to treatment. Your doctor will keep giving you Tecentriq and Avastin until you no longer benefit from it. However, they may be stopped if the side effects become too much of a problem.

Clinical Trial Data

The safety and efficacy of Tecentriq plus Avastin for the treatment of HCC was evaluated in a global, phase 3 trial. The results showed that this combination helped patients live for longer than another medicine called sorafenib.

Keep in mind that everyone is different, and the response and benefit you may experience cannot be predicted. Ask your doctor about the clinical evidence for Tecentriq and Avastin and if the combination is right for you.

Possible side effects of Tecentriq and Avastin

All medicines can have side effects. You will find a list of known side effects in the respective Tecentriq and Avastin Consumer Medicine Information available via links below.

Talk to your doctor to see if Tecentriq and Avastin are right for you.

How to access Tecentriq and Avastin

Tecentriq and Avastin are not funded by PHARMAC. This means that you will need to pay for both medicines at a private treatment centre. If you have health insurance, carefully check what is covered – every health insurance provider has different rules and benefits that cover cancer treatment, surgery, tests and appointments.
To help with the cost of treatment with Tecentriq and Avastin, Roche has created a Cost Share Programme, to help make it more affordable to patients in New Zealand.
The Cost Share Programme is designed to reduce the cost of the medicines, and caps the number of treatment cycles that need to be paid for. This means that you’ll know the maximum amount you need to pay over a certain period of time before you go onto treatment. Other costs, however, such as doctor fees and administration costs, will still apply.

Ready to take the next step?

Because every situation is different, it’s important to speak to your medical team to find out if Tecentriq and Avastin are right for you.

We’ve put together a discussion guide to help you begin a conversation with your doctor. Print it off, take it along to your next appointment, and take notes in the spaces provided.

Talking to your doctor about Tecentriq and Avastin

To help you in this process, we’ve put together a discussion guide to help you begin a conversation with your doctor. Print it off, take it along to your next appointment, and take notes in the spaces provided.

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For further information about private treatment providers click here.

You can also talk to your current doctor about referral to a private doctor or treatment centre.

To learn more about how medicines become available in New Zealand, click here.

Handy resources

These resources contain important safety and side effect information. Please keep in mind that these are not intended to replace medical advice from a doctor or other healthcare professionals.

Tecentriq for HCC patient resource

This resource is intended as an educational support item for patients prescribed TECENTRIQ in combination with bevacizumab for the treatment of HCC.

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Tecentriq SC patient insert

This leaflet is for patients being administered Tecentriq by subcutaneous injection and should be used in conjunction with the Tecentriq for HCC patient resource.

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Tecentriq Consumer Medicine Information
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Avastin Consumer Medicine Information
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Tecentriq patient alert card
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Tecentriq® (atezolizumab) 1200mg/20mL and 840mg/14ml and Tecentriq SC (atezolizumab 1875 mg/15 mL solution for subcutaneous injection) are  Prescription Medicines used for early (has not spread to other parts of the body) and advanced or metastatic (has spread to other parts of the body) non-small cell lung cancer, extensive stage small-cell lung cancer, advanced or metastatic urothelial (bladder and urinary system) cancer, advanced or metastatic triple negative breast cancer and unresectable hepatocellular carcinoma.

Tell your doctor if: you have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus; you have inflammation of the lungs (pneumonitis); you have liver problems, such as hepatitis; you have thyroid problems; you are taking other medicines; you have allergies to any other medicines, foods, preservatives or dyes; you are pregnant or breastfeeding or plan to become pregnant or breastfeed. Tell your doctor right away if you become pregnant during treatment with Tecentriq.

Tell your doctor immediately if you notice any of the following signs and symptoms: inflammation of the lungs (new or worsening cough, shortness of breath and chest pain); inflammation of the liver (yellowing of skin or eyes, nausea, vomiting, bleeding or bruising, dark urine, and stomach pain); inflammation of the intestines (diarrhoea, blood in stools, and stomach pain); inflammation of the thyroid, pituitary and adrenal glands (tiredness, weight loss, weight gain, changes in mood or behaviour, visual disturbances, increased sensitivity to cold or heat, slow or rapid heart rate, hair loss, constipation, headache, and dizziness); type 1 diabetes mellitus (feeling more hungry or thirsty than usual, need to urinate more often, weight loss, and feeling tired); inflammation of the brain or spinal cord (neck stiffness, headache, fever, chills, vomiting, eye sensitivity to light, confusion and sleepiness); inflammation of the nerves (muscle weakness, numbness or tingling in hands and feet); inflammation of the pancreas (abdominal pain, nausea and vomiting); inflammation of the heart muscle (shortness of breath, feeling tired, irregular heart beat or chest pain); inflammation of the sac surrounding the heart (chest pain, difficulty and/or painful breathing, pounding/racing heart beat, fainting and/or light-headedness, swelling of legs or abdomen, pale and/or clammy skin); inflammation of the kidneys (dark and/or frothy urine, high blood pressure, swelling to face, feet, legs and hands; inflammation of muscles (muscle pain or stiffness or skin rash); infusion reactions (fever, chills, shortness of breath and flushing – intravenous formulation only), local reaction at the  injection site (subcutaneous formulation only), excessive activation of the immune system (fever, swollen lymph nodes, skin rash, yellowing of skin and eyes, coughing, difficulty breathing, vomiting, diarrhea headache, changes in vision, weakness), paralysis of the facial muscles, inflammation of the spinal cord (muscle weakness in the legs and arms, numbness, problems with mobility, the bladder and bowel) or any inflammation of the skin.

Possible common side effects may also include: loss of appetite; diarrhoea; shortness of breath; itching of the skin; dry skin; rash; nausea; fever; chills; vomiting; difficulty swallowing; flu-like symptoms; nasal congestion; stomach, back, muscle, bone, joint or throat pain; cough; sore throat; tiredness; common cold; headaches; being short of breath when exercising; urinary tract infection; lung infection; dizziness, light-headedness, looking pale, fainting; bleeding or bruising; mouth ulcers and/or cold sores; constipation; numbness or weakness of the arms and legs; high blood pressure; hair loss; a change in the way things taste.

Tecentriq has risks and benefits. Ask your doctor if Tecentriq is right for you. Use strictly as directed. If symptoms continue or you have side effects, see your healthcare professional. For further information on Tecentriq, please talk to your health professional or visit www.medsafe.govt.nz for Tecentriq Consumer Medicine Information.

  • Tecentriq (intravenous formulation) is PHARMAC funded for patients with locally advanced or metastatic NSCLC that have previously received chemotherapy. A prescription charge and normal oncologist fees may apply.
  • Tecentriq (intravenous formulation) is not PHARMAC funded for urothelial cancer, breast cancer, hepatocellular carcinoma and other lung cancer indications. Tecentriq SC is not PHARMAC funded for any indication. You will need to pay the full cost of the medicine. A prescription charge and normal oncologist fees may apply.

 

Avastin® (bevacizumab), 100 mg/4mL and 400 mg/16 mL vials, is a Prescription Medicine used to treat metastatic (spreading) colorectal, kidney, breast, brain, lung, ovarian and cervical cancers.

Do not use Avastin if: you have had an allergic reaction to Avastin, any of its ingredients or other antibodies, or if you have been coughing or spitting up blood.

Tell your doctor if: you are pregnant or breast-feeding, or plan to become pregnant or breast-feed; you have any other health problems, especially the following: inflammation of the bowel or stomach ulcers, high blood pressure, a history of blood clots or stroke, bleeding problems, bleeding in the lungs or coughing or spitting up blood, low white blood cell counts, you have/ had a fistula, or have a history of diabetes; you have had major surgery in the last 28 days or a wound that has not healed properly; you have had a blocked lung artery (pulmonary embolism); you have heart disease; you have received anthracyclines (e.g. doxorubicin) for cancer, or radiotherapy to your chest; you are 65 years of age or older, or you are taking any other medicines.

Side Effects: Avastin may worsen some chemotherapy side effects when used in combination with chemotherapy agents, including hair loss, nail disorders, pain, redness and/or swelling of your hands and/or soles of your feet, and a feeling of numbness or tingling in the hands or feet.

Tell your doctor immediately or go to your nearest Accident and Emergency Centre if you notice any of the following: severe body pain and/or numbness (unable to sense pain or hot/cold temperatures on your body, arms, and/or legs. Any stomach pain or cramps; severe headache; severe diarrhoea, nausea and vomiting; loss of control of your bladder or bowels; passage of wind or bowel motions through the vagina; coughing or spitting up blood; pain, redness, swelling and warmth over a vein which may suggest blood clots; pain and/or swelling in the lower legs, feet or hands; severe bleeding or problems with your wounds healing after surgery; seizures; confusion; sleepiness/drowsiness or fainting; abscesses (pus-filled sores); severe infection with high fever, chills, headache, confusion and rapid breathing; feeling of numbness or tingling in feet or hands; dry mouth with thirst and/or darkened urine; increased heart rate; shortness of breath; symptoms of an allergic reaction which may include shortness of breath, wheezing or difficulty breathing, swelling of the face, lips, tongue or other parts of the body, or rash, itching or hives on the skin.

Possible common side-effects may also include: high blood pressure (symptoms include, headache, dizziness, ringing in the ears, tiredness, blurred vision); body pain, tiredness/ weakness; diarrhoea, constipation or rectal bleeding; sore mouth or mouth ulcers; loss of appetite, being thirsty; shortness of breath; runny, blocked or bleeding nose; dry, scaling or inflamed skin, change in skin colour; taste changes or loss of taste; blurred vision (including increased production of tears, double visions, drooping eyelid(s), shimmering lights in your vision, sensitivity to light or temporary loss of sight; dizziness; trouble with your balance; headache; migraines; frequent infections with symptoms such as fever, chills or sore throat; changes in your voice or difficulty speaking or swallowing; loss of body weight;  abdominal, pelvic, rectal or back pain.

Avastin has risks and benefits. Ask your oncologist if Avastin is right for you. Use strictly as directed. If symptoms continue or you have side effects, see your healthcare professional. For further information on Avastin, please talk to your health professional or visit www.medsafe.govt.nz for Avastin Consumer Medicine Information.

Avastin is not funded by PHARMAC. You will need to pay the full cost of this medicine. A prescription charge and normal oncologist fees may apply.

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