Not an actual patient/physician; image edited with AI. NCCN Category 1: atezolizumab (TECENTRIQ) + carbo/etop is a Category 1 and preferred immunotherapy/chemotherapy option for first-line treatment of patients with ES-SCLC according to the National Comprehensive Cancer Network ® (NCCN ® ). 5 * † NCCN Category 2A: atezolizumab (TECENTRIQ) + lurbinectedin is a Category 2A and preferred maintenance option for first-line treatment of select patients with ES-SCLC. 5 * ‡§ *NCCN makes no warranties of any kind whatsoever regarding their content, use, or application, and disclaims any responsibility for their application or use in any way. See the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ® ) for detailed recommendations, including other preferred options. † Category 1: based upon high-level evidence (≥1 randomized Phase III trials or high-quality, robust meta-analysis), there is uniform NCCN consensus (≥85% support of the Panel) that the intervention is appropriate. Category 1 and Preferred are two separate recommendations. Only maintenance atezolizumab 1200 mg q3w is Category 1 . ‡ Category 2A: based upon lower-level evidence, there is uniform NCCN consensus (≥85% support of the Panel) that the intervention is appropriate. Category 2A and Preferred are two separate recommendations. § Consider adding lurbinectedin to maintenance atezolizumab in patients who have achieved at least stable disease following 4 cycles of induction chemoimmunotherapy, have an ECOG performance status of 0 to 1, and no history of brain metastases. 1L=first line; carbo/etop=carboplatin/etoposide; ECOG=Eastern Cooperative Oncology Group; OS=overall survival; q3w=every 3 weeks. See the data on 1L maintenance therapy with TECENTRIQ + lurbinectedin Explore trial data for TECENTRIQ + carbo/etop in 1L ES-SCLC View the safety information from TECENTRIQ clinical studies TECENTRIQ ® (atezolizumab), in combination with carboplatin and etoposide, is FDA-approved for the first-line treatment of adult patients with extensive-stage SCLC. Additionally, in combination with lurbinectedin, TECENTRIQ is FDA-approved for the maintenance treatment of adult patients with ES-SCLC whose disease has not progressed after first-line induction therapy with TECENTRIQ, carboplatin and etoposide. TECENTRIQ is thought to work by targeting the PD-L1 protein to enhance the immune response, helping the body to recognize and attack cancer cells. TECENTRIQ may also affect normal cells. Learn more about the proposed mechanism of action for TECENTRIQ and its FDA approval in this indication. TECENTRIQ is administered by intravenous (IV) line. See clinical outcomes from the IMpower133 trial in patients with first-line extensive-stage small cell lung cancer with TECENTRIQ in combination with carboplatin and etoposide. Explore the IMforte trial to learn about clinical outcomes of maintenance treatment with TECENTRIQ and lurbinectedin. Serious and sometimes fatal adverse reactions can occur with TECENTRIQ, including severe and fatal immune-mediated adverse reactions, infusion-related reactions, complications of allogeneic HSCT, and embryo-fetal toxicity. Please see additional side effects of TECENTRIQ. Important Safety Information and Indications TECENTRIQ and TECENTRIQ HYBREZA are indicated: in combination with carboplatin and etoposide, for the first-line treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC) in combination with lurbinectedin, for the maintenance treatment of adult patients with ES-SCLC whose disease has not progressed after first-line induction therapy with TECENTRIQ or TECENTRIQ HYBREZA, carboplatin and etoposide Contraindications TECENTRIQ HYBREZA is contraindicated in patients with known hypersensitivity to hyaluronidase or to any of its excipients. Warnings and Precautions Severe and Fatal Immune-Mediated Adverse Reactions Atezolizumab is a monoclonal antibody that belongs to a class of drugs that bind to either the programmed death-receptor 1 (PD-1) or the PD-ligand 1 (PD-L1), blocking the PD-1/PD-L1 pathway, thereby removing inhibition of the immune response, potentially breaking peripheral tolerance and inducing immune-mediated adverse reactions. The following immune-mediated adverse reactions may not include all possible severe and fatal immune-mediated reactions. Immune-mediated adverse reactions can occur in any organ system or tissue and at any time after starting TECENTRIQ or TECENTRIQ HYBREZA. While immune-mediated adverse reactions usually manifest during treatment with TECENTRIQ or TECENTRIQ HYBREZA, they can also manifest after discontinuation of treatment. Early identification and management of immune-mediated adverse reactions are essential to ensure safe use of TECENTRIQ and TECENTRIQ HYBREZA. Monitor patients closely for symptoms and signs that may be clinical manifestations of underlying immune-mediated adverse reactions. Evaluate liver enzymes, creatinine, and thyroid function at baseline and periodically during treatment. In cases of suspected immune-mediated adverse reactions, initiate appropriate workup to exclude alternative etiologies, including infection. Institute medical management promptly, including specialty consultation as appropriate. Withhold or permanently discontinue TECENTRIQ or TECENTRIQ HYBREZA depending on severity. In general, if TECENTRIQ or TECENTRIQ HYBREZA requires interruption or discontinuation, administer systemic corticosteroid therapy (1 to 2 mg/kg/day prednisone or equivalent) until improvement to Grade 1 or less, then initiate corticosteroid taper and continue to taper over at least 1 month. Consider administration of other systemic immunosuppressants in patients whose immune-mediated adverse reactions are not controlled with corticosteroid therapy. Immune-Mediated Pneumonitis TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated pneumonitis, including fatal adverse reactions. The incidence of pneumonitis is higher in patients who have received prior thoracic radiation Immune-mediated pneumonitis occurred in 3% (83/2616) of patients receiving TECENTRIQ alone, including fatal (<0.1%), Grade 4 (0.2%), Grade 3 (0.8%), and Grade 2 (1.1%) adverse reactions. Pneumonitis led to permanent discontinuation of TECENTRIQ in 0.5% and withholding of TECENTRIQ in 1.5% of patients Systemic corticosteroids were required in 55% (46/83) of patients with pneumonitis who received TECENTRIQ. Pneumonitis resolved in 69% of the 83 patients. Of the 39 patients in whom TECENTRIQ was withheld for pneumonitis, 25 reinitiated TECENTRIQ after symptom improvement; of these, 4% had recurrence of pneumonitis Immune-mediated pneumonitis occurred in 2% (5/247) of patients receiving TECENTRIQ HYBREZA, including Grade 2 (0.8%) and Grade 1 (1.2%) adverse reactions. Pneumonitis led to withholding of TECENTRIQ HYBREZA in 1 patient Systemic corticosteroids were required in 40% (2/5) of patients with pneumonitis who received TECENTRIQ HYBREZA. Pneumonitis resolved in both patients. The single patient in whom TECENTRIQ HYBREZA was withheld for pneumonitis reinitiated TECENTRIQ HYBREZA after symptom improvement Immune-Mediated Colitis TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated colitis. Colitis can present with diarrhea, abdominal pain, and lower gastrointestinal (GI) bleeding. Cytomegalovirus (CMV) infection/reactivation has been reported in patients with corticosteroid-refractory immune-mediated colitis. In cases of corticosteroid-refractory colitis, consider repeating infectious workup to exclude alternative etiologies Immune-mediated colitis occurred in 1% (26/2616) of patients receiving TECENTRIQ alone, including Grade 3 (0.5%) and Grade 2 (0.3%) adverse reactions. Colitis led to permanent discontinuation of TECENTRIQ in 0.2% and withholding of TECENTRIQ in 0.5% of patients. Systemic corticosteroids were required in 50% (13/26) of patients with colitis. Colitis resolved in 73% of the 26 patients. Of the 12 patients in whom TECENTRIQ was withheld for colitis, 8 reinitiated TECENTRIQ after symptom improvement; of these, 25% had recurrence of colitis Immune-Mediated Hepatitis TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated hepatitis, including fatal adverse reactions Immune-mediated hepatitis occurred in 1.8% (48/2616) of patients receiving TECENTRIQ alone, including fatal (<0.1%), Grade 4 (0.2%), Grade 3 (0.5%), and Grade 2 (0.5%) adverse reactions. Hepatitis led to permanent discontinuation of TECENTRIQ in 0.2% and withholding of TECENTRIQ in 0.2% of patients. Systemic corticosteroids were required in 25% (12/48) of patients with hepatitis. Hepatitis resolved in 50% of the 48 patients. Of the 6 patients in whom TECENTRIQ was withheld for hepatitis, 4 reinitiated TECENTRIQ after symptom improvement; of these, none had recurrence of hepatitis Immune-mediated hepatitis occurred in 1.2% (3/247) of patients receiving TECENTRIQ HYBREZA, including Grade 1 (0.4%) and Grade 3 (0.8%) adverse reactions. Hepatitis led to withholding of TECENTRIQ HYBREZA in 0.4% of patients Systemic corticosteroids were required in 67% (2/3) of patients with hepatitis who received TECENTRIQ HYBREZA. Hepatitis resolved in 1 of the 3 patients Immune-Mediated Endocrinopathies Adrenal Insufficiency TECENTRIQ and TECENTRIQ HYBREZA can cause primary or secondary adrenal insufficiency. For Grade 2 or higher adrenal insufficiency, initiate symptomatic treatment, including hormone replacement as clinically indicated Adrenal insufficiency occurred in 0.4% (11/2616) of patients receiving TECENTRIQ alone, including Grade 3 (<0.1%) and Grade 2 (0.2%) adverse reactions. Adrenal insufficiency led to permanent discontinuation of TECENTRIQ in 1 patient and withholding of TECENTRIQ in 1 patient. Systemic corticosteroids were required in 82% (9/11) of patients with adrenal insufficiency; of these, 3 patients remained on systemic corticosteroids. The single patient in whom TECENTRIQ was withheld for adrenal insufficiency did not reinitiate TECENTRIQ Adrenal insufficiency occurred in 0.8% (2/247) of patients receiving TECENTRIQ HYBREZA, including Grade 2 (0.4%) adverse reactions. Adrenal insufficiency led to withholding of TECENTRIQ HYBREZA in both patients. Systemic corticosteroids were required in 50% (1/2) of patients with adrenal insufficiency who received TECENTRIQ HYBREZA; this patient remained on systemic corticosteroids TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated hypophysitis. Hypophysitis can present with acute symptoms associated with mass effect such as headache, photophobia, or visual field cuts. Hypophysitis can cause hypopituitarism. Initiate hormone replacement as clinically indicated Hypophysitis occurred in <0.1% (2/2616) of patients receiving TECENTRIQ alone, including Grade 2 (1 patient, <0.1%) adverse reactions. Hypophysitis led to permanent discontinuation of TECENTRIQ in 1 patient and no patients required withholding of TECENTRIQ. Systemic corticosteroids were required in 50% (1/2) of patients with hypophysitis. Hypophysitis did not resolve in these 2 patients Hypophysitis occurred in 0.4% (1/247) of patients receiving TECENTRIQ HYBREZA, including Grade 1 (0.4%) adverse reactions. Hypophysitis led to withholding of TECENTRIQ HYBREZA in this patient Thyroid Disorders TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated thyroid disorders. Thyroiditis can present with or without endocrinopathy. Hypothyroidism can follow hyperthyroidism. Initiate hormone replacement for hypothyroidism or medical management for hyperthyroidism as clinically indicated Thyroiditis occurred in 0.2% (4/2616) of patients receiving TECENTRIQ alone, including Grade 2 (<0.1%) adverse reactions. Thyroiditis did not lead to permanent discontinuation of TECENTRIQ in any of these patients, but led to withholding of TECENTRIQ in 1 patient. Hormone replacement therapy was required in 75% (3/4) of patients with thyroiditis. Systemic corticosteroids were required in 25% (1/4) of patients with thyroiditis. Thyroiditis resolved in 50% of patients. The single patient in whom TECENTRIQ was withheld for thyroiditis reinitiated TECENTRIQ; this patient did not have recurrence of thyroiditis Thyroiditis occurred in 0.8% (2/247) of patients receiving TECENTRIQ HYBREZA, including Grade 2 (0.4%) adverse reactions. Thyroiditis resolved in 50% of patients Hyperthyroidism occurred in 0.8% (21/2616) of patients receiving TECENTRIQ alone, including Grade 2 (0.4%) adverse reactions. Hyperthyroidism did not lead to permanent discontinuation of TECENTRIQ in any of these patients, but led to withholding of TECENTRIQ in 0.1% of patients. Antithyroid therapy was required in 29% (6/21) of patients with hyperthyroidism. Of these 6 patients, the majority remained on antithyroid treatment. Of the 3 patients in whom TECENTRIQ was withheld for hyperthyroidism, 1 patient reinitiated TECENTRIQ; this patient did not have recurrence of hyperthyroidism Hyperthyroidism occurred in 2% (5/247) of patients receiving TECENTRIQ HYBREZA, including Grade 2 (1.2%) adverse reactions. Hyperthyroidism led to withholding of TECENTRIQ HYBREZA in 0.8% of patients. Antithyroid therapy was required in 40% (2/5) of patients with hyperthyroidism who received TECENTRIQ HYBREZA. Of these 2 patients, 1 remained on antithyroid treatment. Of the 2 patients in whom TECENTRIQ HYBREZA was withheld for hyperthyroidism, 1 patient reinitiated TECENTRIQ HYBREZA; this patient did not have recurrence of hyperthyroidism Hypothyroidism occurred in 4.9% (128/2616) of patients receiving TECENTRIQ alone, including Grade 3 (0.2%) and Grade 2 (3.4%) adverse reactions. Hypothyroidism did not lead to permanent discontinuation of TECENTRIQ in any of these patients, but led to withholding of TECENTRIQ in 0.6% of patients. Hormone replacement therapy was required in 81% (104/128) of patients with hypothyroidism. The majority of patients with hypothyroidism remained on thyroid hormone replacement. Of the 17 patients in whom TECENTRIQ was withheld for hypothyroidism, 8 reinitiated TECENTRIQ after symptom improvement Hypothyroidism occurred in 10% (25/247) of patients receiving TECENTRIQ HYBREZA. Hormone replacement was required in 68% (17/25) of patients with hypothyroidism who received TECENTRIQ HYBREZA. Two patients with hypothyroidism remained on thyroid hormone replacement Hypothyroidism occurred in 11% (277/2421) of patients with NSCLC and SCLC receiving TECENTRIQ in combination with platinum-based chemotherapy, including Grade 4 (<0.1%), Grade 3 (0.3%), and Grade 2 (5.7%) adverse reactions. Hypothyroidism led to permanent discontinuation of TECENTRIQ in 0.1% and withholding of TECENTRIQ in 1.6% of patients. Hormone replacement therapy was required in 71% (198/277) of patients with hypothyroidism. The majority of patients with hypothyroidism remained on thyroid hormone replacement. Of the 39 patients in whom TECENTRIQ was withheld for hypothyroidism, 9 reinitiated TECENTRIQ after symptom improvement Type 1 Diabetes Mellitus, Which Can Present With Diabetic Ketoacidosis TECENTRIQ and TECENTRIQ HYBREZA can cause Type 1 diabetes mellitus. Monitor patients for hyperglycemia or other signs and symptoms of diabetes. Initiate treatment with insulin as clinically indicated Type 1 diabetes mellitus occurred in 0.3% (7/2616) of patients receiving TECENTRIQ alone, including Grade 3 (0.2%) and Grade 2 (<0.1%) adverse reactions. Type 1 diabetes mellitus led to permanent discontinuation of TECENTRIQ in 1 patient and withholding of TECENTRIQ in 2 patients. Treatment with insulin was required for all patients with confirmed Type 1 diabetes mellitus and insulin therapy was continued long-term. Of the 2 patients in whom TECENTRIQ was withheld for Type 1 diabetes mellitus, both reinitiated TECENTRIQ treatment Immune-Mediated Nephritis With Renal Dysfunction TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated nephritis Immune-mediated nephritis with renal dysfunction occurred in <0.1% (1/2616) of patients receiving TECENTRIQ alone, and this adverse reaction was a Grade 3 (<0.1%) adverse reaction. Nephritis led to permanent discontinuation of TECENTRIQ in this patient. This patient required systemic corticosteroids. In this patient, nephritis did not resolve Immune-Mediated Dermatologic Adverse Reactions TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated rash or dermatitis. Exfoliative dermatitis, including Stevens-Johnson syndrome (SJS), DRESS, and toxic epidermal necrolysis (TEN), has occurred with PD-1/PD-L1 blocking antibodies. Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate non-exfoliative rashes Immune-mediated dermatologic adverse reactions occurred in 0.6% (15/2616) of patients receiving TECENTRIQ alone, including Grade 3 (<0.1%) and Grade 2 (0.2%) adverse reactions. Dermatologic adverse reactions led to permanent discontinuation of TECENTRIQ in 0.1% and withholding of TECENTRIQ in 0.2% of patients. Systemic corticosteroids were required in 20% (3/15) of patients with dermatologic adverse reactions. Dermatologic adverse reactions resolved in 87% of the 15 patients. Of the 4 patients in whom TECENTRIQ was withheld for immune-mediated dermatologic adverse reactions, none reinitiated TECENTRIQ One fatal case of an immune-mediated dermatologic adverse reaction, due to TEN, occurred (0.4%, 1/247) in patients receiving TECENTRIQ HYBREZA Other Immune-Mediated Adverse Reactions The following clinically significant immune-mediated adverse reactions occurred at an incidence of <1% (unless otherwise noted) in patients who received TECENTRIQ or were reported with the use of other PD-1/PD-L1 blocking antibodies Cardiac/Vascular : Myocarditis, pericarditis, vasculitis Nervous System : Meningitis, encephalitis, myelitis and demyelination, myasthenic syndrome/myasthenia gravis (including exacerbation), Guillain-Barré syndrome, nerve paresis, autoimmune neuropathy Ocular : Uveitis, iritis, and other ocular inflammatory toxicities can occur. Some cases can be associated with retinal detachment. Various grades of visual impairment, including blindness, can occur. If uveitis occurs in combination with other immune-mediated adverse reactions, consider a Vogt-Koyanagi-Harada-like syndrome, as this may require treatment with systemic steroids to reduce the risk of permanent vision loss Gastrointestinal : Pancreatitis to include increases in serum amylase and lipase levels, gastritis, duodenitis Musculoskeletal and Connective Tissue : Myositis/polymyositis, rhabdomyolysis and associated sequelae including renal failure, arthritis, polymyalgia rheumatic Endocrine : Hypoparathyroidism Hematologic/Immune : Hemolytic anemia, aplastic anemia, hemophagocytic lymphohistiocytosis, systemic inflammatory response syndrome, histiocytic necrotizing lymphadenitis (Kikuchi lymphadenitis), sarcoidosis, immune thrombocytopenic purpura, solid organ transplant rejection, other transplant (including corneal graft) rejection Other : Myocarditis-Myositis-Myasthenia Gravis (or Myasthenia-Like) Overlap Syndrome, reported as the co-occurrence of either two or all three adverse reactions Cardiac/Vascular : Myocarditis, pericarditis, vasculitis Nervous System : Meningitis, encephalitis, myelitis and demyelination, myasthenic syndrome/myasthenia gravis (including exacerbation), Guillain-Barré syndrome, nerve paresis, autoimmune neuropathy Ocular : Uveitis, iritis, and other ocular inflammatory toxicities can occur. Some cases can be associated with retinal detachment. Various grades of visual impairment, including blindness, can occur. If uveitis occurs in combination with other immune-mediated adverse reactions, consider a Vogt-Koyanagi-Harada-like syndrome, as this may require treatment with systemic steroids to reduce the risk of permanent vision loss Gastrointestinal : Pancreatitis to include increases in serum amylase and lipase levels, gastritis, duodenitis Musculoskeletal and Connective Tissue : Myositis/polymyositis, rhabdomyolysis and associated sequelae including renal failure, arthritis, polymyalgia rheumatic Endocrine : Hypoparathyroidism Hematologic/Immune : Hemolytic anemia, aplastic anemia, hemophagocytic lymphohistiocytosis, systemic inflammatory response syndrome, histiocytic necrotizing lymphadenitis (Kikuchi lymphadenitis), sarcoidosis, immune thrombocytopenic purpura, solid organ transplant rejection, other transplant (including corneal graft) rejection Other : Myocarditis-Myositis-Myasthenia Gravis (or Myasthenia-Like) Overlap Syndrome, reported as the co-occurrence of either two or all three adverse reactions Infusion-Related Reactions TECENTRIQ and TECENTRIQ HYBREZA can cause severe or life-threatening infusion-related reactions, including anaphylaxis. Monitor for signs and symptoms of infusion-related reactions. Interrupt/pause, slow the rate of, or permanently discontinue TECENTRIQ or TECENTRIQ HYBREZA based on the severity. For Grade 1 or 2 infusion-related reactions, consider using pre-medications with subsequent doses Infusion-related reactions occurred in 1.3% of patients receiving TECENTRIQ alone, including Grade 3 (0.2%) reactions The frequency and severity of infusion-related reactions were similar whether TECENTRIQ was given as a single agent, in combination with other antineoplastic drugs, and across the recommended dose range Complications of Allogeneic HSCT After PD-1/PD-L1 Inhibitors Fatal and other serious complications can occur in patients who receive allogeneic hematopoietic stem cell transplantation (HSCT) before or after being treated with a PD-1/PD-L1 blocking antibody Transplant-related complications include hyperacute graft-versus-host disease (GVHD), acute GVHD, chronic GVHD, hepatic veno-occlusive disease (VOD) after reduced intensity conditioning, and steroid-requiring febrile syndrome (without an identified infectious cause) These complications may occur despite intervening therapy between PD-1/PD-L1 blockage and allogeneic HSCT Follow patients closely for evidence of transplant-related complications and intervene promptly. Consider the benefits versus risks of treatment with a PD-1/PD-L1 blocking antibody prior to or after an allogeneic HSCT Embryo-Fetal Toxicity Based on its mechanism of action, TECENTRIQ and TECENTRIQ HYBREZA can cause fetal harm when administered to a pregnant woman. There are no available data on the use of TECENTRIQ or TECENTRIQ HYBREZA in pregnant women. Animal studies have demonstrated that inhibition of the PD-L1/PD-1 pathway can lead to increased risk of immune-related rejection of the developing fetus, resulting in fetal death Verify pregnancy status of females of reproductive potential prior to initiating TECENTRIQ or TECENTRIQ HYBREZA. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception during treatment with TECENTRIQ or TECENTRIQ HYBREZA and for at least 5 months after the last dose Use in Specific Populations Nursing Mothers There is no information regarding the presence of TECENTRIQ or TECENTRIQ HYBREZA in human milk, the effects on the breastfed infant, or the effects on milk production. As human IgG is excreted in human milk, the potential for absorption and harm to the infant is unknown Because of the potential for serious adverse reactions in breastfed infants from TECENTRIQ and TECENTRIQ HYBREZA, advise female patients not to breastfeed while taking TECENTRIQ or TECENTRIQ HYBREZA and for at least 5 months after the last dose Based on animal studies, TECENTRIQ and TECENTRIQ HYBREZA may impair fertility in females of reproductive potential while receiving treatment Most Common Adverse Reactions The most common adverse reactions (rate ≥20%) in patients who received TECENTRIQ alone were fatigue/asthenia (48%), decreased appetite (25%), nausea (24%), cough (22%), and dyspnea (22%). The most common adverse reactions (rate ≥10%) in patients who received TECENTRIQ HYBREZA were fatigue (19%), musculoskeletal pain (15%), cough (13%), dyspnea (12%), and decreased appetite (11%). The most common adverse reactions (rate ≥20%) in patients who received TECENTRIQ in combination with other antineoplastic drugs for NSCLC and SCLC were fatigue/asthenia (49%), nausea (38%), alopecia (35%), constipation (29%), diarrhea (28%), and decreased appetite (27%). You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . You may also report side effects to Genentech at 1-888-835-2555 . Please see the TECENTRIQ and TECENTRIQ HYBREZA full Prescribing Information for additional Important Safety Information. TECENTRIQ and TECENTRIQ HYBREZA are indicated: in combination with carboplatin and etoposide, for the first-line treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC) in combination with lurbinectedin, for the maintenance treatment of adult patients with ES-SCLC whose disease has not progressed after first-line induction therapy with TECENTRIQ or TECENTRIQ HYBREZA, carboplatin and etoposide Contraindications TECENTRIQ HYBREZA is contraindicated in patients with known hypersensitivity to hyaluronidase or to any of its excipients. Warnings and Precautions Severe and Fatal Immune-Mediated Adverse Reactions Atezolizumab is a monoclonal antibody that belongs to a class of drugs that bind to either the programmed death-receptor 1 (PD-1) or the PD-ligand 1 (PD-L1), blocking the PD-1/PD-L1 pathway, thereby removing inhibition of the immune response, potentially breaking peripheral tolerance and inducing immune-mediated adverse reactions. The following immune-mediated adverse reactions may not include all possible severe and fatal immune-mediated reactions. Immune-mediated adverse reactions can occur in any organ system or tissue and at any time after starting TECENTRIQ or TECENTRIQ HYBREZA. While immune-mediated adverse reactions usually manifest during treatment with TECENTRIQ or TECENTRIQ HYBREZA, they can also manifest after discontinuation of treatment. Early identification and management of immune-mediated adverse reactions are essential to ensure safe use of TECENTRIQ and TECENTRIQ HYBREZA. Monitor patients closely for symptoms and signs that may be clinical manifestations of underlying immune-mediated adverse reactions. Evaluate liver enzymes, creatinine, and thyroid function at baseline and periodically during treatment. In cases of suspected immune-mediated adverse reactions, initiate appropriate workup to exclude alternative etiologies, including infection. Institute medical management promptly, including specialty consultation as appropriate. Withhold or permanently discontinue TECENTRIQ or TECENTRIQ HYBREZA depending on severity. In general, if TECENTRIQ or TECENTRIQ HYBREZA requires interruption or discontinuation, administer systemic corticosteroid therapy (1 to 2 mg/kg/day prednisone or equivalent) until improvement to Grade 1 or less, then initiate corticosteroid taper and continue to taper over at least 1 month. Consider administration of other systemic immunosuppressants in patients whose immune-mediated adverse reactions are not controlled with corticosteroid therapy. Immune-Mediated Pneumonitis

TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated pneumonitis, including fatal adverse reactions. The incidence of pneumonitis is higher in patients who have received prior thoracic radiation Immune-mediated pneumonitis occurred in 3% (83/2616) of patients receiving TECENTRIQ alone, including fatal (<0.1%), Grade 4 (0.2%), Grade 3 (0.8%), and Grade 2 (1.1%) adverse reactions. Pneumonitis led to permanent discontinuation of TECENTRIQ in 0.5% and withholding of TECENTRIQ in 1.5% of patients Systemic corticosteroids were required in 55% (46/83) of patients with pneumonitis who received TECENTRIQ. Pneumonitis resolved in 69% of the 83 patients. Of the 39 patients in whom TECENTRIQ was withheld for pneumonitis, 25 reinitiated TECENTRIQ after symptom improvement; of these, 4% had recurrence of pneumonitis Immune-mediated pneumonitis occurred in 2% (5/247) of patients receiving TECENTRIQ HYBREZA, including Grade 2 (0.8%) and Grade 1 (1.2%) adverse reactions. Pneumonitis led to withholding of TECENTRIQ HYBREZA in 1 patient Systemic corticosteroids were required in 40% (2/5) of patients with pneumonitis who received TECENTRIQ HYBREZA. Pneumonitis resolved in both patients. The single patient in whom TECENTRIQ HYBREZA was withheld for pneumonitis reinitiated TECENTRIQ HYBREZA after symptom improvement Immune-Mediated Colitis TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated colitis. Colitis can present with diarrhea, abdominal pain, and lower gastrointestinal (GI) bleeding. Cytomegalovirus (CMV) infection/reactivation has been reported in patients with corticosteroid-refractory immune-mediated colitis. In cases of corticosteroid-refractory colitis, consider repeating infectious workup to exclude alternative etiologies Immune-mediated colitis occurred in 1% (26/2616) of patients receiving TECENTRIQ alone, including Grade 3 (0.5%) and Grade 2 (0.3%) adverse reactions. Colitis led to permanent discontinuation of TECENTRIQ in 0.2% and withholding of TECENTRIQ in 0.5% of patients. Systemic corticosteroids were required in 50% (13/26) of patients with colitis. Colitis resolved in 73% of the 26 patients. Of the 12 patients in whom TECENTRIQ was withheld for colitis, 8 reinitiated TECENTRIQ after symptom improvement; of these, 25% had recurrence of colitis Immune-Mediated Hepatitis TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated hepatitis, including fatal adverse reactions Immune-mediated hepatitis occurred in 1.8% (48/2616) of patients receiving TECENTRIQ alone, including fatal (<0.1%), Grade 4 (0.2%), Grade 3 (0.5%), and Grade 2 (0.5%) adverse reactions. Hepatitis led to permanent discontinuation of TECENTRIQ in 0.2% and withholding of TECENTRIQ in 0.2% of patients. Systemic corticosteroids were required in 25% (12/48) of patients with hepatitis. Hepatitis resolved in 50% of the 48 patients. Of the 6 patients in whom TECENTRIQ was withheld for hepatitis, 4 reinitiated TECENTRIQ after symptom improvement; of these, none had recurrence of hepatitis Immune-mediated hepatitis occurred in 1.2% (3/247) of patients receiving TECENTRIQ HYBREZA, including Grade 1 (0.4%) and Grade 3 (0.8%) adverse reactions. Hepatitis led to withholding of TECENTRIQ HYBREZA in 0.4% of patients Systemic corticosteroids were required in 67% (2/3) of patients with hepatitis who received TECENTRIQ HYBREZA. Hepatitis resolved in 1 of the 3 patients Immune-Mediated Endocrinopathies Adrenal Insufficiency TECENTRIQ and TECENTRIQ HYBREZA can cause primary or secondary adrenal insufficiency. For Grade 2 or higher adrenal insufficiency, initiate symptomatic treatment, including hormone replacement as clinically indicated Adrenal insufficiency occurred in 0.4% (11/2616) of patients receiving TECENTRIQ alone, including Grade 3 (<0.1%) and Grade 2 (0.2%) adverse reactions. Adrenal insufficiency led to permanent discontinuation of TECENTRIQ in 1 patient and withholding of TECENTRIQ in 1 patient. Systemic corticosteroids were required in 82% (9/11) of patients with adrenal insufficiency; of these, 3 patients remained on systemic corticosteroids. The single patient in whom TECENTRIQ was withheld for adrenal insufficiency did not reinitiate TECENTRIQ Adrenal insufficiency occurred in 0.8% (2/247) of patients receiving TECENTRIQ HYBREZA, including Grade 2 (0.4%) adverse reactions. Adrenal insufficiency led to withholding of TECENTRIQ HYBREZA in both patients. Systemic corticosteroids were required in 50% (1/2) of patients with adrenal insufficiency who received TECENTRIQ HYBREZA; this patient remained on systemic corticosteroids TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated hypophysitis. Hypophysitis can present with acute symptoms associated with mass effect such as headache, photophobia, or visual field cuts. Hypophysitis can cause hypopituitarism. Initiate hormone replacement as clinically indicated Hypophysitis occurred in <0.1% (2/2616) of patients receiving TECENTRIQ alone, including Grade 2 (1 patient, <0.1%) adverse reactions. Hypophysitis led to permanent discontinuation of TECENTRIQ in 1 patient and no patients required withholding of TECENTRIQ. Systemic corticosteroids were required in 50% (1/2) of patients with hypophysitis. Hypophysitis did not resolve in these 2 patients Hypophysitis occurred in 0.4% (1/247) of patients receiving TECENTRIQ HYBREZA, including Grade 1 (0.4%) adverse reactions. Hypophysitis led to withholding of TECENTRIQ HYBREZA in this patient Thyroid Disorders TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated thyroid disorders. Thyroiditis can present with or without endocrinopathy. Hypothyroidism can follow hyperthyroidism. Initiate hormone replacement for hypothyroidism or medical management for hyperthyroidism as clinically indicated Thyroiditis occurred in 0.2% (4/2616) of patients receiving TECENTRIQ alone, including Grade 2 (<0.1%) adverse reactions. Thyroiditis did not lead to permanent discontinuation of TECENTRIQ in any of these patients, but led to withholding of TECENTRIQ in 1 patient. Hormone replacement therapy was required in 75% (3/4) of patients with thyroiditis. Systemic corticosteroids were required in 25% (1/4) of patients with thyroiditis. Thyroiditis resolved in 50% of patients. The single patient in whom TECENTRIQ was withheld for thyroiditis reinitiated TECENTRIQ; this patient did not have recurrence of thyroiditis Thyroiditis occurred in 0.8% (2/247) of patients receiving TECENTRIQ HYBREZA, including Grade 2 (0.4%) adverse reactions. Thyroiditis resolved in 50% of patients Hyperthyroidism occurred in 0.8% (21/2616) of patients receiving TECENTRIQ alone, including Grade 2 (0.4%) adverse reactions. Hyperthyroidism did not lead to permanent discontinuation of TECENTRIQ in any of these patients, but led to withholding of TECENTRIQ in 0.1% of patients. Antithyroid therapy was required in 29% (6/21) of patients with hyperthyroidism. Of these 6 patients, the majority remained on antithyroid treatment. Of the 3 patients in whom TECENTRIQ was withheld for hyperthyroidism, 1 patient reinitiated TECENTRIQ; this patient did not have recurrence of hyperthyroidism Hyperthyroidism occurred in 2% (5/247) of patients receiving TECENTRIQ HYBREZA, including Grade 2 (1.2%) adverse reactions. Hyperthyroidism led to withholding of TECENTRIQ HYBREZA in 0.8% of patients. Antithyroid therapy was required in 40% (2/5) of patients with hyperthyroidism who received TECENTRIQ HYBREZA. Of these 2 patients, 1 remained on antithyroid treatment. Of the 2 patients in whom TECENTRIQ HYBREZA was withheld for hyperthyroidism, 1 patient reinitiated TECENTRIQ HYBREZA; this patient did not have recurrence of hyperthyroidism Hypothyroidism occurred in 4.9% (128/2616) of patients receiving TECENTRIQ alone, including Grade 3 (0.2%) and Grade 2 (3.4%) adverse reactions. Hypothyroidism did not lead to permanent discontinuation of TECENTRIQ in any of these patients, but led to withholding of TECENTRIQ in 0.6% of patients. Hormone replacement therapy was required in 81% (104/128) of patients with hypothyroidism. The majority of patients with hypothyroidism remained on thyroid hormone replacement. Of the 17 patients in whom TECENTRIQ was withheld for hypothyroidism, 8 reinitiated TECENTRIQ after symptom improvement Hypothyroidism occurred in 10% (25/247) of patients receiving TECENTRIQ HYBREZA. Hormone replacement was required in 68% (17/25) of patients with hypothyroidism who received TECENTRIQ HYBREZA. Two patients with hypothyroidism remained on thyroid hormone replacement Hypothyroidism occurred in 11% (277/2421) of patients with NSCLC and SCLC receiving TECENTRIQ in combination with platinum-based chemotherapy, including Grade 4 (<0.1%), Grade 3 (0.3%), and Grade 2 (5.7%) adverse reactions. Hypothyroidism led to permanent discontinuation of TECENTRIQ in 0.1% and withholding of TECENTRIQ in 1.6% of patients. Hormone replacement therapy was required in 71% (198/277) of patients with hypothyroidism. The majority of patients with hypothyroidism remained on thyroid hormone replacement. Of the 39 patients in whom TECENTRIQ was withheld for hypothyroidism, 9 reinitiated TECENTRIQ after symptom improvement Type 1 Diabetes Mellitus, Which Can Present With Diabetic Ketoacidosis TECENTRIQ and TECENTRIQ HYBREZA can cause Type 1 diabetes mellitus. Monitor patients for hyperglycemia or other signs and symptoms of diabetes. Initiate treatment with insulin as clinically indicated Type 1 diabetes mellitus occurred in 0.3% (7/2616) of patients receiving TECENTRIQ alone, including Grade 3 (0.2%) and Grade 2 (<0.1%) adverse reactions. Type 1 diabetes mellitus led to permanent discontinuation of TECENTRIQ in 1 patient and withholding of TECENTRIQ in 2 patients. Treatment with insulin was required for all patients with confirmed Type 1 diabetes mellitus and insulin therapy was continued long-term. Of the 2 patients in whom TECENTRIQ was withheld for Type 1 diabetes mellitus, both reinitiated TECENTRIQ treatment Immune-Mediated Nephritis With Renal Dysfunction TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated nephritis Immune-mediated nephritis with renal dysfunction occurred in <0.1% (1/2616) of patients receiving TECENTRIQ alone, and this adverse reaction was a Grade 3 (<0.1%) adverse reaction. Nephritis led to permanent discontinuation of TECENTRIQ in this patient. This patient required systemic corticosteroids. In this patient, nephritis did not resolve Immune-Mediated Dermatologic Adverse Reactions TECENTRIQ and TECENTRIQ HYBREZA can cause immune-mediated rash or dermatitis. Exfoliative dermatitis, including Stevens-Johnson syndrome (SJS), DRESS, and toxic epidermal necrolysis (TEN), has occurred with PD-1/PD-L1 blocking antibodies. Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate non-exfoliative rashes Immune-mediated dermatologic adverse reactions occurred in 0.6% (15/2616) of patients receiving TECENTRIQ alone, including Grade 3 (<0.1%) and Grade 2 (0.2%) adverse reactions. Dermatologic adverse reactions led to permanent discontinuation of TECENTRIQ in 0.1% and withholding of TECENTRIQ in 0.2% of patients. Systemic corticosteroids were required in 20% (3/15) of patients with dermatologic adverse reactions. Dermatologic adverse reactions resolved in 87% of the 15 patients. Of the 4 patients in whom TECENTRIQ was withheld for immune-mediated dermatologic adverse reactions, none reinitiated TECENTRIQ One fatal case of an immune-mediated dermatologic adverse reaction, due to TEN, occurred (0.4%, 1/247) in patients receiving TECENTRIQ HYBREZA Other Immune-Mediated Adverse Reactions The following clinically significant immune-mediated adverse reactions occurred at an incidence of <1% (unless otherwise noted) in patients who received TECENTRIQ or were reported with the use of other PD-1/PD-L1 blocking antibodies Cardiac/Vascular : Myocarditis, pericarditis, vasculitis Nervous System : Meningitis, encephalitis, myelitis and demyelination, myasthenic syndrome/myasthenia gravis (including exacerbation), Guillain-Barré syndrome, nerve paresis, autoimmune neuropathy Ocular : Uveitis, iritis, and other ocular inflammatory toxicities can occur. Some cases can be associated with retinal detachment. Various grades of visual impairment, including blindness, can occur. If uveitis occurs in combination with other immune-mediated adverse reactions, consider a Vogt-Koyanagi-Harada-like syndrome, as this may require treatment with systemic steroids to reduce the risk of permanent vision loss Gastrointestinal : Pancreatitis to include increases in serum amylase and lipase levels, gastritis, duodenitis Musculoskeletal and Connective Tissue : Myositis/polymyositis, rhabdomyolysis and associated sequelae including renal failure, arthritis, polymyalgia rheumatic Endocrine : Hypoparathyroidism Hematologic/Immune : Hemolytic anemia, aplastic anemia, hemophagocytic lymphohistiocytosis, systemic inflammatory response syndrome, histiocytic necrotizing lymphadenitis (Kikuchi lymphadenitis), sarcoidosis, immune thrombocytopenic purpura, solid organ transplant rejection, other transplant (including corneal graft) rejection Other : Myocarditis-Myositis-Myasthenia Gravis (or Myasthenia-Like) Overlap Syndrome, reported as the co-occurrence of either two or all three adverse reactions Cardiac/Vascular : Myocarditis, pericarditis, vasculitis Nervous System : Meningitis, encephalitis, myelitis and demyelination, myasthenic syndrome/myasthenia gravis (including exacerbation), Guillain-Barré syndrome, nerve paresis, autoimmune neuropathy Ocular : Uveitis, iritis, and other ocular inflammatory toxicities can occur. Some cases can be associated with retinal detachment. Various grades of visual impairment, including blindness, can occur. If uveitis occurs in combination with other immune-mediated adverse reactions, consider a Vogt-Koyanagi-Harada-like syndrome, as this may require treatment with systemic steroids to reduce the risk of permanent vision loss Gastrointestinal : Pancreatitis to include increases in serum amylase and lipase levels, gastritis, duodenitis Musculoskeletal and Connective Tissue : Myositis/polymyositis, rhabdomyolysis and associated sequelae including renal failure, arthritis, polymyalgia rheumatic Endocrine : Hypoparathyroidism Hematologic/Immune : Hemolytic anemia, aplastic anemia, hemophagocytic lymphohistiocytosis, systemic inflammatory response syndrome, histiocytic necrotizing lymphadenitis (Kikuchi lymphadenitis), sarcoidosis, immune thrombocytopenic purpura, solid organ transplant rejection, other transplant (including corneal graft) rejection Other : Myocarditis-Myositis-Myasthenia Gravis (or Myasthenia-Like) Overlap Syndrome, reported as the co-occurrence of either two or all three adverse reactions Infusion-Related Reactions TECENTRIQ and TECENTRIQ HYBREZA can cause severe or life-threatening infusion-related reactions, including anaphylaxis. Monitor for signs and symptoms of infusion-related reactions. Interrupt/pause, slow the rate of, or permanently discontinue TECENTRIQ or TECENTRIQ HYBREZA based on the severity. For Grade 1 or 2 infusion-related reactions, consider using pre-medications with subsequent doses Infusion-related reactions occurred in 1.3% of patients receiving TECENTRIQ alone, including Grade 3 (0.2%) reactions The frequency and severity of infusion-related reactions were similar whether TECENTRIQ was given as a single agent, in combination with other antineoplastic drugs, and across the recommended dose range Complications of Allogeneic HSCT After PD-1/PD-L1 Inhibitors Fatal and other serious complications can occur in patients who receive allogeneic hematopoietic stem cell transplantation (HSCT) before or after being treated with a PD-1/PD-L1 blocking antibody Transplant-related complications include hyperacute graft-versus-host disease (GVHD), acute GVHD, chronic GVHD, hepatic veno-occlusive disease (VOD) after reduced intensity conditioning, and steroid-requiring febrile syndrome (without an identified infectious cause) These complications may occur despite intervening therapy between PD-1/PD-L1 blockage and allogeneic HSCT Follow patients closely for evidence of transplant-related complications and intervene promptly. Consider the benefits versus risks of treatment with a PD-1/PD-L1 blocking antibody prior to or after an allogeneic HSCT Embryo-Fetal Toxicity Based on its mechanism of action, TECENTRIQ and TECENTRIQ HYBREZA can cause fetal harm when administered to a pregnant woman. There are no available data on the use of TECENTRIQ or TECENTRIQ HYBREZA in pregnant women. Animal studies have demonstrated that inhibition of the PD-L1/PD-1 pathway can lead to increased risk of immune-related rejection of the developing fetus, resulting in fetal death Verify pregnancy status of females of reproductive potential prior to initiating TECENTRIQ or TECENTRIQ HYBREZA. Advise females of reproductive potential of the potential risk to a fetus and to use effective contraception during treatment with TECENTRIQ or TECENTRIQ HYBREZA and for at least 5 months after the last dose Use in Specific Populations Nursing Mothers There is no information regarding the presence of TECENTRIQ or TECENTRIQ HYBREZA in human milk, the effects on the breastfed infant, or the effects on milk production. As human IgG is excreted in human milk, the potential for absorption and harm to the infant is unknown Because of the potential for serious adverse reactions in breastfed infants from TECENTRIQ and TECENTRIQ HYBREZA, advise female patients not to breastfeed while taking TECENTRIQ or TECENTRIQ HYBREZA and for at least 5 months after the last dose Based on animal studies, TECENTRIQ and TECENTRIQ HYBREZA may impair fertility in females of reproductive potential while receiving treatment Most Common Adverse Reactions The most common adverse reactions (rate ≥20%) in patients who received TECENTRIQ alone were fatigue/asthenia (48%), decreased appetite (25%), nausea (24%), cough (22%), and dyspnea (22%). The most common adverse reactions (rate ≥10%) in patients who received TECENTRIQ HYBREZA were fatigue (19%), musculoskeletal pain (15%), cough (13%), dyspnea (12%), and decreased appetite (11%). The most common adverse reactions (rate ≥20%) in patients who received TECENTRIQ in combination with other antineoplastic drugs for NSCLC and SCLC were fatigue/asthenia (49%), nausea (38%), alopecia (35%), constipation (29%), diarrhea (28%), and decreased appetite (27%). You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . You may also report side effects to Genentech at 1-888-835-2555 . Please see the TECENTRIQ and TECENTRIQ HYBREZA full Prescribing Information for additional Important Safety Information. TECENTRIQ Prescribing Information. Genentech, Inc. TECENTRIQ Prescribing Information. Genentech, Inc. Paz-Ares L, Borghaei H, Liu SV, et al. Efficacy and safety of first-line maintenance therapy with lurbinectedin plus atezolizumab in extensive-stage small-cell lung cancer (IMforte): a randomised, multicentre, open-label, phase 3 trial. Lancet . 2025;405:2129​-2143. Paz-Ares L, Borghaei H, Liu SV, et al. Efficacy and safety of first-line maintenance therapy with lurbinectedin plus atezolizumab in extensive-stage small-cell lung cancer (IMforte): a randomised, multicentre, open-label, phase 3 trial. Lancet . 2025;405:2129​-2143. Horn L, Mansfield AS, Szczȩsna A, et al; IMpower133 Study Group. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med . 2018;379:2220​-2229. Horn L, Mansfield AS, Szczȩsna A, et al; IMpower133 Study Group. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med . 2018;379:2220​-2229. TECENTRIQ HYBREZA Prescribing Information. Genentech, Inc. TECENTRIQ HYBREZA Prescribing Information. Genentech, Inc. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Cell Lung Cancer V.2.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed September 16, 2025. To view the most recent and complete version of the guideline, go online to www.NCCN.org . Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Cell Lung Cancer V.2.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed September 16, 2025. To view the most recent and complete version of the guideline, go online to www.NCCN.org . Sabari JK, Lok BH, Laird JH, Poirier JT, Rudin CM. Unravelling the biology of SCLC: implications for therapy. Nat Rev Clin Oncol . 2017;14:549-561. Sabari JK, Lok BH, Laird JH, Poirier JT, Rudin CM. Unravelling the biology of SCLC: implications for therapy. Nat Rev Clin Oncol . 2017;14:549-561. Kao S, Reck M, Liu SV, et al. Whole exome sequencing analyses from IMpower133 and 6-year overall survival from IMbrella A in patients with extensive-stage small cell lung cancer (ES-SCLC) treated with atezolizumab. Presented at: Annual Congress of the European Society for Medical Oncology (ESMO Asia); December 6-8, 2024; Singapore. Kao S, Reck M, Liu SV, et al. Whole exome sequencing analyses from IMpower133 and 6-year overall survival from IMbrella A in patients with extensive-stage small cell lung cancer (ES-SCLC) treated with atezolizumab. Presented at: Annual Congress of the European Society for Medical Oncology (ESMO Asia); December 6-8, 2024; Singapore. Data on file. Genentech, Inc. Data on file. Genentech, Inc. Liu S, Dziadziuszko R, Sugawara S, et al. Five-year survival in patients with ES-SCLC treated with atezolizumab in IMpower133: IMbrella A extension study results. Presented at: International Association for the Study of Lung Cancer 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore. Liu S, Dziadziuszko R, Sugawara S, et al. Five-year survival in patients with ES-SCLC treated with atezolizumab in IMpower133: IMbrella A extension study results. Presented at: International Association for the Study of Lung Cancer 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore. Data on file. Roche. Data on file. Roche. Zepzelca (lurbinectedin) Prescribing Information. Jazz Pharmaceuticals, Inc. Zepzelca (lurbinectedin) Prescribing Information. Jazz Pharmaceuticals, Inc. TECENTRIQ Prescribing Information. Genentech, Inc. TECENTRIQ Prescribing Information. Genentech, Inc. TECENTRIQ Prescribing Information. Genentech, Inc. TECENTRIQ Prescribing Information. Genentech, Inc. Paz-Ares L, Borghaei H, Liu SV, et al. Efficacy and safety of first-line maintenance therapy with lurbinectedin plus atezolizumab in extensive-stage small-cell lung cancer (IMforte): a randomised, multicentre, open-label, phase 3 trial. Lancet . 2025;405:2129​-2143. Paz-Ares L, Borghaei H, Liu SV, et al. Efficacy and safety of first-line maintenance therapy with lurbinectedin plus atezolizumab in extensive-stage small-cell lung cancer (IMforte): a randomised, multicentre, open-label, phase 3 trial. Lancet . 2025;405:2129​-2143. Paz-Ares L, Borghaei H, Liu SV, et al. Efficacy and safety of first-line maintenance therapy with lurbinectedin plus atezolizumab in extensive-stage small-cell lung cancer (IMforte): a randomised, multicentre, open-label, phase 3 trial. Lancet . 2025;405:2129​-2143. Paz-Ares L, Borghaei H, Liu SV, et al. Efficacy and safety of first-line maintenance therapy with lurbinectedin plus atezolizumab in extensive-stage small-cell lung cancer (IMforte): a randomised, multicentre, open-label, phase 3 trial. Lancet . 2025;405:2129​-2143. Horn L, Mansfield AS, Szczȩsna A, et al; IMpower133 Study Group. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med . 2018;379:2220​-2229. Horn L, Mansfield AS, Szczȩsna A, et al; IMpower133 Study Group. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med . 2018;379:2220​-2229. Horn L, Mansfield AS, Szczȩsna A, et al; IMpower133 Study Group. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med . 2018;379:2220​-2229. Horn L, Mansfield AS, Szczȩsna A, et al; IMpower133 Study Group. First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N Engl J Med . 2018;379:2220​-2229. TECENTRIQ HYBREZA Prescribing Information. Genentech, Inc. TECENTRIQ HYBREZA Prescribing Information. Genentech, Inc. TECENTRIQ HYBREZA Prescribing Information. Genentech, Inc. TECENTRIQ HYBREZA Prescribing Information. Genentech, Inc. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Cell Lung Cancer V.2.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed September 16, 2025. To view the most recent and complete version of the guideline, go online to www.NCCN.org . Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Cell Lung Cancer V.2.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed September 16, 2025. To view the most recent and complete version of the guideline, go online to www.NCCN.org . Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Cell Lung Cancer V.2.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed September 16, 2025. To view the most recent and complete version of the guideline, go online to www.NCCN.org . Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Cell Lung Cancer V.2.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed September 16, 2025. To view the most recent and complete version of the guideline, go online to www.NCCN.org . Sabari JK, Lok BH, Laird JH, Poirier JT, Rudin CM. Unravelling the biology of SCLC: implications for therapy. Nat Rev Clin Oncol . 2017;14:549-561. Sabari JK, Lok BH, Laird JH, Poirier JT, Rudin CM. Unravelling the biology of SCLC: implications for therapy. Nat Rev Clin Oncol . 2017;14:549-561. Sabari JK, Lok BH, Laird JH, Poirier JT, Rudin CM. Unravelling the biology of SCLC: implications for therapy. Nat Rev Clin Oncol . 2017;14:549-561. Sabari JK, Lok BH, Laird JH, Poirier JT, Rudin CM. Unravelling the biology of SCLC: implications for therapy. Nat Rev Clin Oncol . 2017;14:549-561. Kao S, Reck M, Liu SV, et al. Whole exome sequencing analyses from IMpower133 and 6-year overall survival from IMbrella A in patients with extensive-stage small cell lung cancer (ES-SCLC) treated with atezolizumab. Presented at: Annual Congress of the European Society for Medical Oncology (ESMO Asia); December 6-8, 2024; Singapore. Kao S, Reck M, Liu SV, et al. Whole exome sequencing analyses from IMpower133 and 6-year overall survival from IMbrella A in patients with extensive-stage small cell lung cancer (ES-SCLC) treated with atezolizumab. Presented at: Annual Congress of the European Society for Medical Oncology (ESMO Asia); December 6-8, 2024; Singapore. Kao S, Reck M, Liu SV, et al. Whole exome sequencing analyses from IMpower133 and 6-year overall survival from IMbrella A in patients with extensive-stage small cell lung cancer (ES-SCLC) treated with atezolizumab. Presented at: Annual Congress of the European Society for Medical Oncology (ESMO Asia); December 6-8, 2024; Singapore. Kao S, Reck M, Liu SV, et al. Whole exome sequencing analyses from IMpower133 and 6-year overall survival from IMbrella A in patients with extensive-stage small cell lung cancer (ES-SCLC) treated with atezolizumab. Presented at: Annual Congress of the European Society for Medical Oncology (ESMO Asia); December 6-8, 2024; Singapore. Data on file. Genentech, Inc. Data on file. Genentech, Inc. Data on file. Genentech, Inc. Data on file. Genentech, Inc. Liu S, Dziadziuszko R, Sugawara S, et al. Five-year survival in patients with ES-SCLC treated with atezolizumab in IMpower133: IMbrella A extension study results. Presented at: International Association for the Study of Lung Cancer 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore. Liu S, Dziadziuszko R, Sugawara S, et al. Five-year survival in patients with ES-SCLC treated with atezolizumab in IMpower133: IMbrella A extension study results. Presented at: International Association for the Study of Lung Cancer 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore. Liu S, Dziadziuszko R, Sugawara S, et al. Five-year survival in patients with ES-SCLC treated with atezolizumab in IMpower133: IMbrella A extension study results. Presented at: International Association for the Study of Lung Cancer 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore. Liu S, Dziadziuszko R, Sugawara S, et al. Five-year survival in patients with ES-SCLC treated with atezolizumab in IMpower133: IMbrella A extension study results. Presented at: International Association for the Study of Lung Cancer 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore. Data on file. Roche. Data on file. Roche. Data on file. Roche. Data on file. Roche. Zepzelca (lurbinectedin) Prescribing Information. Jazz Pharmaceuticals, Inc. Zepzelca (lurbinectedin) Prescribing Information. Jazz Pharmaceuticals, Inc. Zepzelca (lurbinectedin) Prescribing Information. Jazz Pharmaceuticals, Inc. Zepzelca (lurbinectedin) Prescribing Information. Jazz Pharmaceuticals, Inc. The link you have selected will take you away from this site to one that is not owned or controlled by Genentech, Inc. Genentech, Inc. makes no representation as to the accuracy of the information contained on sites we do not own or control. Genentech does not recommend and does not endorse the content on any third-party websites. Your use of third-party websites is at your own risk and subject to the terms and conditions of use for such sites.