ATEZOLIZUMAB/ HYALURONIDASE-TQJS INJ,SOLN
Clinical Criteria Summary
Exclusion Criteria
- Autoimmune disease
- Immunosuppression including corticosteroid equivalent to >10 mg per day of prednisone
- Primary immunodeficiency
- History of allogeneic hematopoietic stem cell or solid organ transplant
- Pregnancy (i.e. known pregnancy or positive pregnancy test)
- Lactating
Inclusion Criteria
- Indications & Administration
- Indication is FDA approved
- Off-label use supported by high-level published data
- If administering with chemotherapy and/or bevacizumab, administer prior to chemotherapy and/or bevacizumab if given on the same day
- Care Coordination & Documentation
- Care is provided by a VA/VA Community Care oncology or hematology provider
- Goals of care and role of Palliative Care consult have been discussed and documented
- Performance Status
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
- Reproductive Health & Contraception
- Female patients of child-bearing potential and male patients with female partners of child-bearing potential: counseling provided on contraception and risks vs. benefits of treatment. Use effective contraception during therapy and for 5 months after the last dose.
- Product Substitution/Transition
- Do not substitute atezolizumab/hyaluronidase SubQ for atezolizumab IV on a mg per mg basis. Patients may transition products at the next dose.