Skip to main content

Atezolizumab and Abraxane A1701

A1701

 

Information leaflet on Atezolizumab and Abraxane

 

This leaflet provides information for patients having treatment with Atezolizumab and Abraxane.  The leaflet will explain what Atezolizumab and Abraxane is and when and how it is given.  It will also tell you about common side effects that you may experience.  Contact telephone numbers and details of how to obtain further information on Atezolizumab and Abraxane are given at the end of the leaflet.

 

Your ‘specialist team’ refers to your oncology team at Velindre Cancer Centre which includes doctors, specialist nurses and nurse or pharmacy prescribers.

 

 

 

What is Atezolizumab and Abraxane and why am I having it?

Atezolizumab is a treatment which helps your immune system to attack and destroy cancer cells. Atezolizumab is used to treat your type of cancer, but it is not a chemotherapy drug, it is immunotherapy.

Abraxane is a chemotherapy treatment using a well established drug called paclitaxel.  Abraxane is prepared in a different way to standard paclitaxel.  This reduces the possibility of allergic reactions

Atezolizumab is given by subcutaneous injection under the skin on your thigh.  

Abraxane is given in a drip.

 

How often will I receive Atezolizumab and Abraxane?

For this treatment to be most effective, it is given at specific time intervals. These are known as cycles.

For your particular treatment it is usual to have Atezolizumab every 3 weeks and Abraxane every week 28 cycle 

 

Your specialist team will discuss how often you will receive your treatment with you and how long you will have to continue having the treatment.

 

How often will I see the specialist team?

You will need to be reviewed regularly whilst having this treatment. This will either be face to face in an outpatient clinic or a telephone consultation. The specialist team who prescribe your treatment will check how you are feeling and discuss any problems you may have.

 

You will also have regular blood tests. This is so we can check how the treatment is affecting you.  If your blood results are satisfactory, your treatment will be given.

 

How is Abraxane given?

Abraxane is given through a drip into a vein in the back of your hand or arm. Alternatively it may be suggested that a fine tube called a PICC is inserted into a large vein in your upper arm.  This will remain in place throughout the course of your treatment.  Your doctor or nurse will discuss this further with you, if required, and we have a leaflet that tells you more about PICC lines. 

 

The administration of Atezolizumab by subcutaneous injection will take approx. 7 minutes.  The injection site will change from your left to right thigh each treatment cycle.  In order for the Nurse to give the injection into your leg it is advisable to wear comfortable loose-fitting clothing, for example a skirt or trousers, to enable access to your thigh for administration on the day of your treatment

 

Where will my treatment be given?

The treatments will be given in the day case treatment areas at Velindre Cancer Centre or in one of the Velindre Cancer Centre outreach clinics

 

How long will I be in the hospital?

It will take approximately 2 and a half hours for your Atezolizumab and Abraxane appointment. Please allow extra time for your first 2 appointments.  This is because we give the Abraxane over a longer time to make sure you are OK.

 

Can I bring relatives and friends with me?

You are welcome to bring someone to stay with you during your treatment. Space is limited so there is not usually room for more than one person.  Treatment areas are not suitable for young children.

 

Reactions during the treatment

If you experience any of the following during the treatment please tell your nurse straight away:

 

  • Feeling hot and feverish
  • Chills or shivering
  • Headache
  • Dizziness or faintness
  • Problems with breathing or wheeze.
  • Rash or itching
  • Feeling sick or vomiting
  • Facial swelling

 

If any of these occur we will slow down or stop the Abraxane until you feel better. We may need to give you medication to help to settle the sensitivity reaction. The Abraxane can usually start again, and usually without any further problems.

 

What are the possible side effects?

Some people have very few side effects whilst others may experience more. 

 

Atezolizumab Injection Site

You may have injection site reactions. It is usually mild and around the injection site there may be pain, red skin or rash.

 

Some of the side effects happen because Atezolizumab affects the immune system causing inflammation of other parts of the body such as the skin, the bowels and hormone producing glands. Most, if not all severe side effects can be controlled by the use of steroid medication immediately either as tablets or through a drip.  Hospital admission may become necessary, however, for severe immune related reactions.

 

It is important that if you have more severe side effects that you contact Velindre Cancer Centre. The telephone number is at the end of the leaflet.  Further details of when to contact Velindre are included in the individual side effects listed below.

 

If you are admitted to another hospital, you must inform the doctors and the nurses that you are taking Atezolizumab and Abraxane.  It is possible you could be having an immune reaction and should be started on steroids. The doctors and nurses need to contact Velindre Cancer Centre for advice.  They can either telephone the treatment helpline or speak to your oncologist.

 

You will be given an alert card, please show this to the nurses or doctors if you are admitted to any hospital.

 

Flu-like symptoms/Chills/ Infection

 

You may experience flu-like symptoms and chills. However, if you have signs of infection, such as cough, cold, passing urine more frequently or stinging or coughing up green phlegm, ring Velindre cancer centre on the telephone at the end of the leaflet.

 

If you develop an infection whilst your white blood cells are low, you are at risk of sepsis, this can be life threatening.

Contact Velindre Cancer Centre immediately if you develop any signs of infection, for example flu like symptoms or a temperature above 37.5°centigrade.  The telephone number is at the end of the leaflet.

 

Hair loss

Unfortunately you will lose your hair with this chemotherapy.  This is only temporary.  Your hair will grow back when your treatment has finished.  A method known as ‘scalp cooling’ or ‘cold capping’ can be used to prevent hair loss. If you decide to have cold cap, please allow approximately 1½ hours extra for your treatment.  Otherwise we can arrange a wig if you would like one.  If you want to know more about scalp cooling or wigs please speak to your nurse.  

We have a leaflet that tells you more about coping with hair loss.  Please ask your nurse for a copy.

 

Nausea and vomiting

Your treatment can cause nausea and vomiting. If you experience nausea, we can give you anti sickness medication to help. If the anti sickness medication does not help or you vomit, contact Velindre Cancer Centre for advice.  The telephone number is at the end of the leaflet.

 

Effects on the bowels  

 

This treatment has been known to cause diarrhoea. 

If you experience diarrhoea it is important that you drink plenty of fluids.  Medication is available to control diarrhoea.  If you have 4 or more bowel movements in 24 hours above what is normal for you please contact Velindre Cancer Centre immediately.  The telephone number is at the end of the leaflet.

 

Please note:

If you have any of the symptoms below you must inform Velindre Cancer Centre immediately, the telephone numbers are at the end of the leaflet.

 

  • 4 or more bowel movements in 24 hours above what is normal for you.
  • if you have any problems with diarrhoea or an increase in bowel movements which lasts for more than 3 days.
  • If you have severe stomach pains
  • Or if you have blood or mucus in your bowel motions

 

There is a risk of inflammation of the bowel (colitis) or rupture of the bowel (perforation) in a small minority of patients. Therefore it is important to inform us of any of the above symptoms or abdominal pain or swelling.

 

Effects on the skin

You may develop an itching skin rash which can be treated with moisturising cream.  However if you get a severe skin reaction you may need to be treated in hospital.

 

Please contact Velindre Cancer Centre if:

 

  • If the rash covers more than half of your body and is painful.
  • If you have large blisters or your skin is peeling.
  • If your skin feels very raw.
  • If you have itchy eyes.
  • If you have mouth ulcers. 

 

Effects on your hormone glands

 

Atezolizumab can cause inflammation of the glands that produce the different hormones (chemicals that control many of the body’s functions) in the body. Symptoms will vary depending on which glands are affected.

 

It is important to contact Velindre cancer Centre if you have the following :

  •  a headache that will not go away
  •  nausea and vomiting
  •  severe mood swings.
  •  severe tiredness (mild to moderate tiredness is  common with Atezolizumab and Abraxane)
  • If you have a noticeable increase in energy levels or restlessness.
  • If you feel forgetful and/or confused

 

Tiredness and fatigue

 

Your treatment can make you feel more tired than usual.  It is important to listen to your body and rest if you need to, but carry out your normal activities if you feel able.  Some people find it beneficial to take gentle exercise as well as taking rest.  If you are sleeping more than 50% during the daytime you need to contact Velindre Cancer Centre on the number at the end of the leaflet

 

Myalgia Painful or aching joints

Abraxane can cause pains or aches into your joints.  This is most likely to occur 2-3 days after each treatment.  Let your doctor or nurse know if this happens as we can give you pain killers to help. 

Effects on the nerves of your hands and feet

Abraxane can affect the nerves of your hands and feet.  This may lead to a loss of sensation, tingling or pins and needles.  If this occurs please tell your doctor or nurse at your next clinic visit as we may need to change your treatment.

These symptoms may increase as you have more cycles of chemotherapy.  It is important to be extra careful when exposing your hands and feet to hot or cold temperatures. These symptoms usually go away within a few months of finishing your treatment. 

 

Other side effects

Women sometimes find that chemotherapy treatment affects their periods.  They could become heavier, lighter or even stop altogether.  

It is important you do not become pregnant or father a child whilst having chemotherapy treatment as chemotherapy could damage the unborn baby.  

This chemotherapy can increase your skin’s sensitivity to the sun.  It is best to avoid strong sunlight and wear a hat and use a sun block when in the sun.

Risk of bleeding

Your treatment may reduce the production of platelets (which help the blood to clot).  This will increase your risk of bruising or bleeding.  If you notice any excessive bruising on your body or bleeding such as nosebleeds or bleeding from your gums you should contact Velindre Cancer Centre for advice.  The telephone number is at the end of the leaflet. Tell your team if you take medicines which may affect bleeding, such as aspirin, warfarin or vitamin E.

 

Effects on breathing:

 

If you experience shortness of breath, cough or any breathing difficulties it is important to inform the treatment helpline in Velindre cancer centre, on the telephone at the end of the leaflet. It is possible to develop a condition called pneumonitis, which can be life-threatening and needs to be treated.

 

 

Effects on the liver

 

This is rare, but if you are affected you may feel more tired than usual and may also feel sick or vomit.  Your doctor will give you anti sickness medicine to take. 

 

Please contact Velindre Cancer Centre if:

 

  • If you vomit more than once in 24 hours despite taking anti sickness medication.

 

More severe effects on the liver are very rare but can be very serious so you should contact Velindre Cancer Centre if:

 

  • If you have yellowing of your skin and the whites of your eyes.
  • If you have darker urine than normal.
  • If you have unusual bruising or bleeding

 

Other side effects:

You may have these additional side effects, if so please contact Velindre Cancer Centre:

 

  • Increased frequency of passing urine and/or thirst.
  • Dizziness or light headedness.
  • Decreased urine output.
  • Blurred or altered vision or red sore eyes.
  • Low blood pressure
  • Altered sensation to hands/feet or other areas of the body.

 

 

 

Other information

It is important you do not become pregnant, breastfeed or father a child whilst having Atezolizumab and Abraxane treatment and for 6 months after treatment.

It is recommended not to have live vaccines whilst on Atezolizumab and Abraxane.

Inform your oncologist if you have any autoimmune diseases for example: Crohns, Ulcerative colitis, Lupus, Multiple sclerosis.

Inform your oncologist if you are on long term steroids.

 

Side effects may continue for up to 6 months after treatment.  If you have any side effects contact your consultant. If you are admitted to hospital or see your GP during this period, inform the doctor you have had Atezolizumab, an immunotherapy medication, and show them your alert card.

 

Sometimes cancer drugs can have very serious side effects which can be life threatening. It is important to inform Velindre cancer centre if you are concerned about any side-effects.

 

A diagnosis of cancer can increase your risk of developing a blood clot (thrombosis), and having cancer treatment may increase this risk further.  It is important to tell your doctor immediately if you have symptoms such as pain, redness and swelling in your leg, or breathlessness and chest pain. 

 

Blood clots can be very serious.  However, most clots can usually be successfully treated with drugs to thin the blood.  Your doctor or nurse can give you more information.

 

Manufacturer’s patient information leaflets

Velindre leaflets provide information about very common and common side-effects: for more information regarding the less common side-effects please refer to the manufacturers patient information leaflets, obtained from Velindre pharmacy and/or on the internet at www.medicines.org.uk. Sometimes patients may find these leaflets difficult to read however. Please ask if you would like a copy from your doctor or from

 

Contact telephone numbers

 

Velindre Cancer Centre          029 2061 5888

If you are unwell at home and need immediate attention at any time of the day or night ask for the treatment helpline

 

 

Pharmacy department            029 2061 5888 ext 6223

Monday – Friday 9am – 5pm for queries about your medicines

 

Tenovus freephone                0808 808 1010

cancer helpline

This leaflet was written by health professionals.  The information contained in this leaflet is evidence based.  The leaflet has been approved by doctors, nurses, pharmacists and patients.  It is reviewed and updated every 2 years.

 

Prepared July 2020

Reviewed November 2023

 

 plain-english (3)