Considerations before starting^1-3

• Oesophageal varices should be screened for and subsequently treated as per clinical practice
• Pre-existing hypertension should be adequately controlled
• Carefully consider the risk of aneurysms and/or artery dissections in patients with risk factors such as hypertension or history of aneurysm
• AST, ALT, bilirubin, thyroid function, proteinuria by dipstick urinalysis, blood glucose and renal function should be monitored
• Consider appropriate management of patients with abnormal thyroid function tests at baseline
• The use of systemic corticosteroids or immunosuppressants before starting treatment should be avoided because of their potential interference with the pharmacodynamic activity and efficacy of TECENTRIQ
• Avastin should not be initiated for at least 28 days following major surgery or until the surgical wound is fully healed 
• Fertility preservation strategies should be discussed with women of child-bearing potential because Avastin may impair female fertility
• Consider a dental examination and appropriate preventive dentistry because invasive dental procedures are a risk factor for osteonecrosis of the jaw in patients on Avastin
• Refer to the TECENTRIQ and Avastin SmPCs for details of contraindications, warnings and precautions

Dosing and administration^1–4

Eligible patients should be administered treatment infusions every 3 weeks as follows:

^{Other dosing schedules are available, for more information please see the smpc}

• Treatment should continue until loss of clinical benefit or unmanageable toxicity
• Dose reduction for adverse reactions is not recommended. If indicated, therapy should either be permanently discontinued or temporarily suspended

See the outcomes that could be achieved with TECENTRIQ + Avastin

Managing AEs^1,2

Most immune-related AEs occurring during TECENTRIQ treatment are reversible with appropriate management

• Most immune-related AEs were reversible with interruptions of TECENTRIQ and initiation of corticosteroids and/or supportive care
• For suspected immune-related AEs, thorough evaluation to confirm aetiology or exclude other causes should be performed
• Based on the severity of the AE, TECENTRIQ should be withheld and corticosteroids administered
  
• Once improved to grade ≤1, corticosteroids should be tapered over ≥1 month*
  
• TECENTRIQ must be permanently discontinued for any grade 3 immune-related AE that recurs and for any grade 4 immune-related AE, except for endocrinopathies that are controlled with replacement hormones
  

_{*Based on limited data from clinical studies in patients whose immune-related adverse reactions could not be controlled with systemic corticosteroid use, other systemic immunosuppressants may be considered.}

View the safety profile of TECENTRIQ + Avastin

Risk management materials to support you and your patients^1,2

• You must discuss the risks of TECENTRIQ therapy with your patients
• Patients must be provided with the Tecentriq patient alert card, which forms part of the Risk Management Plan
• Please contact Medical Information for risk management support regarding Avastin

View the safety profile of TECENTRIQ + Avastin