Our Therapies

TECENTRIQ HYBREZA® Infusion Therapy

Next-generation infusion care - Violet Health Infusion Care

About TECENTRIQ HYBREZA® Injection Therapy

TECENTRIQ HYBREZA® (atezolizumab and hyaluronidase-tqjs) is a fixed-combination biologic given as a subcutaneous injection rather than an intravenous infusion. It was the first subcutaneous checkpoint inhibitor approved in the United States. Atezolizumab is a PD-L1 blocking antibody: rather than attacking cancer cells directly, it binds PD-L1 on tumor cells and immune cells and blocks its connections to PD-1 and B7.1, which helps release the brakes on your own T cells so they can recognize and attack the cancer. Hyaluronidase is an enzyme that temporarily increases the permeability of the tissue under the skin, allowing the full dose of atezolizumab to be delivered as an injection.

Conditions treated by this therapy

TECENTRIQ HYBREZA® is FDA-approved for all of the adult indications approved for intravenous TECENTRIQ®, and for patients 12 years and older who weigh 40 kg or more with alveolar soft part sarcoma. Your care team may consider this therapy if you have:

Non-small cell lung cancer (NSCLC) as adjuvant treatment after surgery and platinum-based chemotherapy, in stage II to IIIA disease with PD-L1 expression on 1% or more of tumor cells
First-line metastatic NSCLC as a single agent, when the tumor has high PD-L1 expression and no EGFR or ALK abnormality
First-line metastatic non-squamous NSCLC with bevacizumab, paclitaxel, and carboplatin, or with paclitaxel protein-bound and carboplatin, in tumors without EGFR or ALK abnormalities
Metastatic NSCLC after platinum-based chemotherapy, and after an appropriate targeted therapy for tumors with EGFR or ALK abnormalities
Extensive-stage small cell lung cancer (ES-SCLC), first-line with carboplatin and etoposide, and as maintenance treatment with lurbinectedin for disease that has not progressed after that first-line regimen
Unresectable or metastatic hepatocellular carcinoma (liver cancer) with bevacizumab, in patients who have not received prior systemic therapy
Unresectable or metastatic melanoma with a BRAF V600 mutation, given with cobimetinib and vemurafenib
Unresectable or metastatic alveolar soft part sarcoma (ASPS), in adults and in patients 12 years and older who weigh 40 kg or more

Several of these indications require FDA-approved testing to confirm PD-L1 expression, EGFR or ALK status, or a BRAF V600 mutation before treatment begins. Your oncologist will confirm whether the subcutaneous formulation is right for your diagnosis, since dosing differs from intravenous atezolizumab.

TECENTRIQ HYBREZA® Price

The cost of prescription medications can vary depending on your insurance coverage. If you're concerned about the price of your medication:

Contact your insurance provider to understand your coverage
Ask your doctor or pharmacist about lower-cost alternatives
Check with the drug manufacturer about financial assistance programs
Explore patient assistance options if you're uninsured or underinsured

Remember, many resources exist to help patients access necessary medications. Don't hesitate to ask for help if you're struggling with medication costs. No patient should go without necessary treatment due to financial limitations. If you have questions about financial assistance opportunities, contact a member of our Violet Health team.

What to Expect During TECENTRIQ HYBREZA® Injection Therapy

When you arrive at our Violet Health location, you'll settle into a private, welcoming space designed with your comfort and peace of mind in mind. Because TECENTRIQ HYBREZA® is given as an injection rather than an infusion, there is no IV line and no infusion pump. Before and during your visit, our experienced team will:

Review your current health status and any symptoms you've noticed
Check your vital signs and review recent lab work, including thyroid, liver, and kidney function, before treatment begins
Choose and prepare your injection site in the thigh, rotating between the left and right thigh from visit to visit and avoiding skin that is red, bruised, tender, or hard
Administer your TECENTRIQ HYBREZA® injection over approximately seven minutes
Monitor you afterward for any administration-related or hypersensitivity reactions
Protect your privacy and comfort throughout the visit

The injection itself takes about seven minutes, considerably less time than the 30- to 60-minute intravenous infusion of TECENTRIQ®, though you should still plan for time at check-in, assessment, and post-treatment monitoring. Every patient comes in on the same three-week rhythm. The thigh is the only approved injection site, so if you are receiving other subcutaneous medications, those will be given somewhere other than the thighs. When TECENTRIQ HYBREZA® is given on the same day as chemotherapy, bevacizumab, or lurbinectedin, it is administered first and your visit will be longer. If your regimen includes oral medications such as cobimetinib and vemurafenib, you'll continue taking those at home between visits. TECENTRIQ HYBREZA® must be given by a healthcare provider and is never self-administered at home.

TECENTRIQ HYBREZA® Side Effects

As with any medication, TECENTRIQ HYBREZA® may cause side effects. In the IMscin001 trial, the safety profile of the subcutaneous injection was comparable to intravenous atezolizumab, with the addition of injection site reactions. Being informed helps you know what to watch for and when to contact your healthcare team. Common Side Effects:

Fatigue or weakness
Injection site reactions, including redness, swelling, pain, or firmness in the thigh
Decreased appetite and weight loss
Nausea, vomiting, diarrhea, or constipation
Cough and shortness of breath
Muscle, bone, and joint pain, and back pain
Rash and itching (pruritus)
Underactive thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism)
Fever, headache, and urinary tract infection
Hair loss, mouth sores, and numbness or tingling in the hands and feet, when given with chemotherapy
High blood pressure and protein in the urine, when given with bevacizumab
Rash, fever, and liver enzyme elevations, when given with cobimetinib and vemurafenib
Changes in blood counts, liver enzymes, kidney function, blood sugar, and electrolyte levels

TECENTRIQ HYBREZA® can cause your immune system to attack healthy organs and tissues. These immune-mediated reactions can become severe or life-threatening, can affect any organ system, and may occur during treatment or after it has ended. Please alert our clinical staff or seek medical attention immediately if you experience any of the following:

Lung inflammation (pneumonitis), including new or worsening cough, chest pain, or shortness of breath. Tell your care team if you have had prior radiation to the chest, which may increase this risk
Intestinal inflammation (colitis), including diarrhea, stool changes, severe abdominal pain, or blood or mucus in the stool
Liver problems (hepatitis), including yellowing of the skin or eyes, dark urine, severe nausea, or pain on the right side of the abdomen
Hormone gland problems affecting the thyroid, adrenal glands, or pituitary gland, including headaches, extreme tiredness, weight changes, dizziness or fainting, constipation, hair loss, or feeling cold
New or worsening type 1 diabetes, including increased thirst or hunger, frequent urination, and unexplained weight loss
Kidney problems (nephritis), including changes in the amount or color of your urine or swelling in the ankles
Serious skin reactions, including rash, blistering or peeling skin, painful sores or ulcers in the mouth, nose, throat, or genital area, fever or flu-like symptoms, and swollen lymph nodes
Serious infections, including fever, chills, cough with mucus, burning with urination, or frequent urination
Administration-related and hypersensitivity reactions, including chills or shaking, itching or rash, flushing, wheezing, dizziness, feeling faint, fever, and low blood pressure
Other immune-mediated problems affecting the heart, nerves, eyes, muscles, or pancreas, including irregular or rapid heartbeat, muscle pain or weakness, eye problems or vision changes, and numbness and tingling

Not interchangeable with IV TECENTRIQ®: TECENTRIQ HYBREZA® has different recommended dosing and administration instructions and must never be given intravenously or substituted for intravenous atezolizumab. It is for subcutaneous use in the thigh only.

Allergy to hyaluronidase: Tell your care team about any known hypersensitivity to hyaluronidase or hyaluronidase-containing products, or any prior reaction to a medicine given with hyaluronidase.

Transplant complications: Tell your care team if you have had, or are planning to have, an organ transplant or an allogeneic stem cell transplant. Serious complications, including transplant rejection and graft-versus-host disease, can occur in patients treated with a PD-L1 blocking antibody.

Pregnancy warning: TECENTRIQ HYBREZA® may harm an unborn baby. Tell your care team if you are pregnant or plan to become pregnant. Use effective birth control during treatment and for five months after your last dose, and do not breastfeed during treatment or for five months after your last dose.

Patient Forms

Before you attend your first appointment at Violet Health, please make sure to review the documents below. Please contact us if you have any questions!