Tecentriq (Atezolizumab) vs Keytruda (pembrolizumab)

Tecentriq (atezolizumab) and Keytruda (pembrolizumab) are both immunotherapy drugs that work by targeting and inhibiting specific proteins to help the immune system recognize and fight cancer cells. Tecentriq targets the protein PD-L1, which some cancer cells express to avoid immune detection, and is approved for use in certain types of bladder, lung, breast, and other cancers. Keytruda targets the PD-1 receptor on immune cells and is used to treat a wider range of cancers, including melanoma, lung cancer, head and neck cancer, and others; the choice between these medications would depend on the specific type of cancer, its PD-L1 expression, and individual patient factors, with a healthcare provider's guidance being essential in making the right decision.

Difference between Tecentriq and Keytruda

Metric	Tecentriq (Atezolizumab)	Keytruda (pembrolizumab)
Generic name	Atezolizumab	Pembrolizumab
Indications	Urothelial carcinoma, non-small cell lung cancer, triple-negative breast cancer, small cell lung cancer, hepatocellular carcinoma, and others	Melanoma, non-small cell lung cancer, head and neck squamous cell cancer, classical Hodgkin lymphoma, urothelial carcinoma, microsatellite instability-high cancer, gastric cancer, esophageal cancer, cervical cancer, hepatocellular carcinoma, Merkel cell carcinoma, renal cell carcinoma, endometrial carcinoma, and others
Mechanism of action	PD-L1 inhibitor, blocks the interaction of PD-L1 with PD-1 and B7.1 receptors	PD-1 inhibitor, blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2
Brand names	Tecentriq	Keytruda
Administrative route	Intravenous infusion	Intravenous infusion
Side effects	Fatigue, decreased appetite, nausea, urinary tract infection, fever, and constipation	Fatigue, cough, nausea, itching, rash, decreased appetite, constipation, joint pain, and diarrhea
Contraindications	Individuals with hypersensitivity to atezolizumab or any of its excipients	Individuals with hypersensitivity to pembrolizumab or any of its excipients
Drug class	Monoclonal antibody, immune checkpoint inhibitor	Monoclonal antibody, immune checkpoint inhibitor
Manufacturer	Genentech (Roche)	Merck & Co.

Efficacy

Tecentriq (Atezolizumab) in Treating Lung Cancer

Tecentriq (atezolizumab) is a monoclonal antibody designed to target and inhibit the programmed death-ligand 1 (PD-L1), which is involved in the suppression of the immune system. By inhibiting PD-L1, Tecentriq may enhance the body's immune response against cancer cells. In the context of lung cancer, Tecentriq has shown efficacy in treating non-small cell lung cancer (NSCLC), particularly in patients whose tumors express PD-L1 and who have not received prior chemotherapy. The drug has been approved for use in several countries based on clinical trials that demonstrated improved survival rates in comparison to traditional chemotherapy.

One of the pivotal clinical trials for Tecentriq, the OAK study, showed that patients with previously treated NSCLC had a median overall survival of 13.8 months when treated with Tecentriq, compared to 9.6 months with docetaxel, a standard chemotherapy agent. This improvement in survival was particularly notable in patients with high PD-L1 expression in their tumors. Additionally, Tecentriq has been evaluated in combination with other therapies, which may offer further benefits for certain patient populations.

Keytruda (Pembrolizumab) in Treating Lung Cancer

Keytruda (pembrolizumab) is another monoclonal antibody that targets the programmed cell death protein 1 (PD-1) receptor on immune cells. By blocking this receptor, Keytruda helps to activate T cells to recognize and attack cancer cells. Pembrolizumab has been extensively studied in lung cancer, specifically NSCLC, and has been approved for the treatment of patients with metastatic NSCLC whose tumors express PD-L1, as well as for the first-line treatment of certain patients with NSCLC, depending on the tumor's genetic characteristics.

The efficacy of Keytruda in lung cancer was highlighted in the KEYNOTE-024 trial, where pembrolizumab significantly improved progression-free survival and overall survival compared to standard chemotherapy in patients with high PD-L1 expression and no EGFR or ALK genomic tumor aberrations. The median overall survival was not reached for pembrolizumab at the time of the analysis, compared to 14.2 months for chemotherapy. Furthermore, Keytruda has shown benefits when used in combination with other treatments, including chemotherapy and targeted therapies, which can provide additional options for patients with advanced lung cancer.

Regulatory Agency Approvals

Tecentriq

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Pharmaceuticals and Medical Devices Agency (PMDA), Japan
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

Keytruda

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

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