Is Atezolizumab Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Atezolizumab? Is Atezolizumab safe for nursing mother and child? Does Atezolizumab extracts into breast milk? Does Atezolizumab has any long term or short term side effects on infants? Can Atezolizumab influence milk supply or can Atezolizumab decrease milk supply in lactating mothers?

No information is available on the clinical use of atezolizumab during breastfeeding. Because atezolizumab is a large protein molecule with a molecular weight of 145,000, the amount in milk is likely to be very low and absorption is unlikely because it is probably destroyed in the infant's gastrointestinal tract. Until more data become available, atezolizumab should be used with caution or avoided during breastfeeding, especially while nursing a newborn or preterm infant. The manufacturer recommends that breastfeeding be discontinued during atezolizumab therapy and for at least 5 months after the last dose. Atezolizumab is a human immunoglobulin G1 (IgG1) antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G in mature milk by 60 to 79%.[1][2] A study of 67 colostrum samples that underwent Holder pasteurization found that IgG amounts decreased by 34 to 40%. Specific IgG subclasses decreased by different amounts, with IgG1 activity decreasing by about 37%.[3] None of the studies measured IgG activity.