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Atezolizumab side effects: what 38,600 FDA adverse event reports show

Atezolizumab · Tecentriq · 1,081 reaction terms · 101,253 drug–reaction co-reports · data 2026-09-14
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Drug class

Programmed Death Receptor-1 Blocking Antibody

FDA label (Established Pharmacologic Class) · compare the class

Brand names

Tecentriq

openFDA label

Who reports

38,600 reports · 96% serious · 9,820 with death outcome · 37% female

openFDA FAERS counts, all years, deduplication not applied

Used for

TECENTRIQ is a programmed death-ligand 1 (PD-L1) blocking antibody indicated: Non-Small Cell Lung Cancer (NSCLC) as adjuvant treatment following resection and platinum-based chemotherapy for adult patients with Stage II to IIIA NSCLC whose tumors have PD-L1 expression on ≥ 1% of tumor cells, as determined by an FDA-authorized test.

FDA label, Indications and Usage

What it is

Atezolizumab is a programmed cell death ligand 1 (PD-L1) blocking antibody. Atezolizumab is an Fc-engineered, humanized, non-glycosylated IgG1 kappa immunoglobulin that has a calculated molecular mass of 145 kDa.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 5Labeled (related wording) 12Likely indication confounding 3Lab value / disease marker 2Not in label — unassessed 18
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 1,041 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Mixed hepatocellular cholangiocarcinoma22511.7
285.2–918.0ROR 512.0 · χ² 5,473 / p <1e-300
213.6 EB05 148.7 · IC025 +4.6
3/3 methods agree
Likely indication confounding
shares a disease stem with the indications wording
serious n=22 · 100% cliniciannot reported in cached trials
Paraneoplastic neurological syndrome35210.4
142.3–311.0ROR 210.6 · χ² 5,086 / p <1e-300
139.9 EB05 105.1 · IC025 +5.0
3/3 methods agree
Not in label — unassessedserious n=35 · 100% cliniciannot reported in cached trials
Alpha 1 foetoprotein decreased11202.9
101.4–406.2ROR 203.0 · χ² 1,459 / p <1e-300
117.8 EB05 70.2 · IC025 +3.3
3/3 methods agree
Lab value / disease markerserious n=11not reported in cached trials
Reactive capillary endothelial proliferation14187.2
101.9–344.1ROR 187.3 · χ² 1,785 / p <1e-300
117.2 EB05 74.2 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=14not reported in cached trials
Urinary occult blood11154.9
79.2–302.9ROR 154.9 · χ² 1,187 / p 2e-260
100.0 EB05 59.6 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Tumour fistulisation12133.7
71.1–251.8ROR 133.8 · χ² 1,161 / p 1e-254
92.0 EB05 56.1 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=12not reported in cached trials
Tumour thrombosis38108.7
76.7–154.1ROR 108.8 · χ² 3,281 / p <1e-300
86.7 EB05 65.9 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=38 · ♀ 0% (drug 37%)not reported in cached trials
Tumour hyperprogression3079.5
54.2–116.6ROR 79.5 · χ² 1,956 / p <1e-300
66.5 EB05 48.8 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=30 · 100% cliniciannot reported in cached trials
Bleeding varicose vein6776.6
59.3–98.9ROR 76.7 · χ² 4,307 / p <1e-300
65.9 EB05 53.7 · IC025 +5.1
3/3 methods agree
Not in label — unassessedserious n=67 · ♀ 15% (drug 37%) · 94% cliniciannot reported in cached trials
Liver carcinoma ruptured3176.1
52.2–110.8ROR 76.1 · χ² 1,946 / p <1e-300
64.2 EB05 47.4 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=31 · ♀ 0% (drug 37%) · 100% cliniciannot reported in cached trials
Varicose vein ruptured3770.4
50.0–99.2ROR 70.5 · χ² 2,177 / p <1e-300
60.5 EB05 45.8 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious n=37 · ♀ 0% (drug 37%) · 100% cliniciannot reported in cached trials
Tumour rupture5863.6
48.4–83.5ROR 63.7 · χ² 3,138 / p <1e-300
55.9 EB05 44.9 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=58 · ♀ 16% (drug 37%) · 91% cliniciannot reported in cached trials
Hepatocellular carcinoma79162.8
58.4–67.5ROR 64.1 · χ² 43,002 / p <1e-300
56.2 EB05 53.0 · IC025 +5.6
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious PRR 33.9 · 91% cliniciannot reported in cached trials
Oesophageal varices haemorrhage22161.4
53.4–70.5ROR 61.7 · χ² 11,724 / p <1e-300
54.9 EB05 49.1 · IC025 +5.4
3/3 methods agree
Labeled adverse reaction
exact term
serious n=220 · ♀ 6% (drug 37%) · 98% cliniciannot reported in cached trials
Immune-mediated hepatitis18857.5
49.5–66.8ROR 57.7 · χ² 9,370 / p <1e-300
51.7 EB05 45.8 · IC025 +5.3
3/3 methods agree
Labeled adverse reaction
exact term
serious n=188 · 97% clinicianNCT03498716: 1/1,093 (0.1%) on Atezolizumab (serious AE)
Hepatic rupture1950.3
31.4–80.5ROR 50.3 · χ² 795 / p 3e-175
44.2 EB05 29.9 · IC025 +3.6
3/3 methods agree
Not in label — unassessedserious n=19not reported in cached trials
Alpha 1 foetoprotein increased5948.9
37.4–63.8ROR 48.9 · χ² 2,491 / p <1e-300
44.3 EB05 35.6 · IC025 +4.6
3/3 methods agree
Lab value / disease markerserious n=57 · ♀ 14% (drug 37%)not reported in cached trials
Skin candida4045.5
33.0–62.9ROR 45.6 · χ² 1,565 / p <1e-300
41.3 EB05 31.6 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=40 · ♀ 100% (drug 37%) · 100% cliniciannot reported in cached trials
Hypophysitis14642.4
35.9–50.2ROR 42.6 · χ² 5,437 / p <1e-300
39.2 EB05 34.2 · IC025 +4.8
3/3 methods agree
Labeled adverse reaction
exact term
serious n=142 · 100% clinicianNCT03498716: 3/1,093 (0.3%) on Atezolizumab (serious AE)
Triple negative breast cancer4541.8
30.9–56.6ROR 41.8 · χ² 1,624 / p <1e-300
38.3 EB05 29.8 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=44 · ♀ 100% (drug 37%) · 100% cliniciannot reported in cached trials
Thrombophlebitis migrans2341.4
27.1–63.3ROR 41.5 · χ² 805 / p 2e-177
37.4 EB05 26.3 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=23 · 100% cliniciannot reported in cached trials
Adrenocorticotropic hormone deficiency6140.8
31.4–52.9ROR 40.9 · χ² 2,163 / p <1e-300
37.6 EB05 30.3 · IC025 +4.4
3/3 methods agree
Not in label — unassessedserious n=61 · 100% clinicianNCT03498716: 2/1,093 (0.2%) on Atezolizumab (serious AE)
Limbic encephalitis1939.6
24.8–63.0ROR 39.6 · χ² 629 / p 3e-139
35.7 EB05 24.2 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=19not reported in cached trials
Infected neoplasm1535.2
20.9–59.3ROR 35.2 · χ² 436 / p 4e-97
31.9 EB05 20.5 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=15not reported in cached trials
Nephritis19634.2
29.6–39.4ROR 34.3 · χ² 5,899 / p <1e-300
32.1 EB05 28.5 · IC025 +4.7
3/3 methods agree
Labeled adverse reaction
exact term
serious n=193 · 99% clinicianNCT03498716: 1/1,084 (0.1%) on Atezolizumab (serious AE)
Immune-mediated pneumonitis1434.0
19.8–58.4ROR 34.1 · χ² 392 / p 2e-87
30.9 EB05 19.5 · IC025 +3.0
3/3 methods agree
Labeled adverse reaction
exact term
serious n=14not reported in cached trials
Lymphocytic hypophysitis1633.3
20.1–55.2ROR 33.3 · χ² 442 / p 2e-98
30.4 EB05 19.8 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Small cell lung cancer8232.3
25.8–40.3ROR 32.3 · χ² 2,313 / p <1e-300
30.3 EB05 25.2 · IC025 +4.3
3/3 methods agree
Likely indication confounding
term in indications; also in warnings
serious n=81not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Atezolizumab as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (5 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Death4,2642.7
2.6–2.8ROR 2.9 · χ² 4,725 / p <1e-300
2.7 EB05 2.6 · IC025 +1.4
3/3 methods agree
Outcome field, not a reactionserious PRR 1.6NCT03498716: 3/1,093 (0.3%) on Atezolizumab (serious AE)
Off label use (used outside approved label)3,5842.2
2.2–2.3ROR 2.4 · χ² 2,579 / p <1e-300
2.2 EB05 2.2 · IC025 +1.1
3/3 methods agree
Reporting / coding artifactserious PRR 2.3not reported in cached trials
Disease progression2,16310.1
9.7–10.6ROR 10.7 · χ² 17,562 / p <1e-300
10.0 EB05 9.6 · IC025 +3.2
3/3 methods agree
Reporting / coding artifactserious PRR 6.7not reported in cached trials
Pyrexia (fever)1,7492.8
2.6–2.9ROR 2.8 · χ² 1,973 / p <1e-300
2.7 EB05 2.6 · IC025 +1.4
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.0NCT03498716: 13/1,093 (1.2%) on Atezolizumab (serious AE)
Diarrhoea (diarrhea)1,7101.4
1.4–1.5ROR 1.5 · χ² 241 / p 1e-54
1.4 EB05 1.4 · IC025 +0.5Labeled adverse reaction
exact term
serious PRR 1.5 · 91% clinicianNCT03498716: 3/1,093 (0.3%) on Atezolizumab (serious AE)
Fatigue (tiredness)1,4991.0
1.0–1.1ROR 1.1 · χ² 3 / p 0.033
1.0 EB05 1.0 · IC025 -0.0
PRR-only: not supported by EBGM or IC
Labeled adverse reaction
exact term
serious PRR 1.1NCT03498716: 2/1,093 (0.2%) on Atezolizumab (serious AE)
Anaemia (low red blood cells)1,3513.9
3.7–4.1ROR 4.0 · χ² 2,872 / p <1e-300
3.8 EB05 3.7 · IC025 +1.9
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.5 · 96% clinicianNCT03498716: 6/1,093 (0.5%) on Atezolizumab (serious AE)
Pneumonia (lung infection)1,1341.9
1.8–2.0ROR 1.9 · χ² 496 / p 4e-110
1.9 EB05 1.8 · IC025 +0.8Labeled adverse reaction
exact term
serious PRR 1.2 · 91% clinicianNCT03498716: 1/1,084 (0.1%) on Atezolizumab (serious AE)
Decreased appetite (loss of appetite)1,1102.6
2.5–2.8ROR 2.7 · χ² 1,109 / p 2e-243
2.6 EB05 2.5 · IC025 +1.3
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.3NCT03498716: 2/1,093 (0.2%) on Atezolizumab (serious AE)
Hypothyroidism1,07919.0
17.9–20.2ROR 19.5 · χ² 17,800 / p <1e-300
18.4 EB05 17.5 · IC025 +4.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 11.9 · 96% clinicianNCT03498716: 2/1,093 (0.2%) on Atezolizumab (serious AE)
Nausea1,0620.7
0.7–0.8ROR 0.7 · χ² 109 / p 8e-26
0.7 EB05 0.7 · IC025 -0.6
PRR-only: not supported by EBGM or IC
Labeled adverse reaction
exact term
serious PRR 0.8 · ♀ 59% (drug 37%)NCT03498716: 2/1,093 (0.2%) on Atezolizumab (serious AE)
Dyspnoea (shortness of breath)1,0281.0
0.9–1.0ROR 1.0 · χ² 0 / p 0.343
1.0 EB05 0.9 · IC025 -0.1
PRR-only: not supported by EBGM or IC
Labeled adverse reaction
exact term
serious PRR 0.8NCT03498716: 1/1,093 (0.1%) on Atezolizumab (serious AE)
Hypertension (high blood pressure)9962.6
2.4–2.7ROR 2.6 · χ² 949 / p 9e-209
2.5 EB05 2.4 · IC025 +1.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 1.9 · 94% clinicianNCT03038100: 5/642 (0.8%) on Atezolizumab; 4/644 (0.6%) control (serious AE)
Pneumonitis96520.1
18.8–21.4ROR 20.6 · χ² 16,860 / p <1e-300
19.4 EB05 18.4 · IC025 +4.2
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 12.0 · 97% clinicianNCT03498716: 18/1,093 (1.6%) on Atezolizumab (serious AE)
Rash9581.2
1.1–1.3ROR 1.2 · χ² 32 / p 6e-9
1.2 EB05 1.1 · IC025 +0.2Labeled adverse reaction
exact term
serious PRR 1.5 · 93% clinicianNCT03498716: 1/1,093 (0.1%) on Atezolizumab (serious AE)

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Atezolizumab?

In FDA FAERS, the most frequently co-reported reaction terms for Atezolizumab are pyrexia, diarrhoea, fatigue, anaemia, pneumonia, decreased appetite. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Atezolizumab have an FDA boxed warning?

No. The FDA label retrieved for Atezolizumab has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Atezolizumab causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.