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OP RESEARCH PRO00037831 ML44719 ABDELRAHIM ARM A	

Types:      Research Oncology Treatment
Synonyms:  

Cycle 1	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once over 60 Minutes for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once over 90 Minutes for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 2	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 3	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 4	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 5	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	TSH AND FREE T4	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
		  	T3, FREE	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
			Labs
  	HEPATITIS B SURFACE ANTIGEN	Interval: --	Occurrences: --		  	HEPATITIS B SURFACE ANTIBODY	Interval: --	Occurrences: --		  	HEPATITIS B CORE ANTIBODY TOTAL	Interval: --	Occurrences: --		  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 6	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Procedures
  	EGD-EXTERNAL	Interval: --	Occurrences: --	Comments:	See TABLE 3 for cohort specific Requirements and managements of varices
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 7	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 8	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 9	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	TSH AND FREE T4	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
		  	T3, FREE	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
			Labs
  	HEPATITIS B SURFACE ANTIGEN	Interval: --	Occurrences: --		  	HEPATITIS B SURFACE ANTIBODY	Interval: --	Occurrences: --		  	HEPATITIS B CORE ANTIBODY TOTAL	Interval: --	Occurrences: --		  	HEPATITIS B VIRUS (HBV), QUANTITATIVE PCR	Interval: --	Occurrences: --			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 10	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 11	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 12	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Procedures
  	EGD-EXTERNAL	Interval: --	Occurrences: --	Comments:	See TABLE 3 for cohort specific Requirements and managements of varices
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 13	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	TSH AND FREE T4	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
		  	T3, FREE	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 14	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 15	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 16	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 17	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	TSH AND FREE T4	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
		  	T3, FREE	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 18	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 19	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 20	Repeat 1 time	Cycle length: 21 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
Cycle 21	Repeat 1 time	Cycle length: 30 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Appointment Requests
  	INFUSION APPOINTMENT REQUEST	Interval: --	Occurrences: --			Line Care
  	INSERT PERIPHERAL IV OR ACCESS PORTACATH	Interval: --	Occurrences: --		  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Provider Communication
  	ONC PROVIDER COMMUNICATION 2	Interval: --	Occurrences: --	Comments:	"Dose Modifications and Management for Atezolizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim"
			Provider Communication
  	ONC PROVIDER COMMUNICATION 3	Interval: --	Occurrences: --	Comments:	Dose Modifications and Management for Bevacizumab Treatment: Refer to Section 6.5 
Protocol Access Hyperlink:   ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	TSH AND FREE T4	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
		  	T3, FREE	Interval: --	Occurrences: --	Comments:	Local laboratory assessments from each cycle must be reviewed prior to study treatment administration for each cycle (or applicable cycle).
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Treatment Conditions
  	TREATMENT CONDITIONS	Interval: --	Occurrences: --	Comments:	Proteinuria: 
For 2+ dipstick: Continue bevacizumab and collect 24-hour urine protein (or protein:creatinine ratio as an alternative per local practice) prior to subsequent bevacizumab administration. 
o For 3+ dipstick: Obtain 24-hour urine prior to administering bevacizumab. 
o Withhold bevacizumab for urinary protein GREATER than or EQUAL to 2 g/24 hours. 
		  	TREATMENT CONDITIONS 3	Interval: --	Occurrences: --	Comments:	Do NOT administer Bevacizumab within 28 days of surgery/procedure and until the surgical wound is fully healed or within 14 days of port placement.
			Nursing Orders
  	TREATMENT CONDITIONS 10	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 75,000;
o ALT / AST GREATER than or EQUAL 3x ULN or Total Bilirubin GREATER than ULN.
			Nursing Orders
  	TREATMENT CONDITIONS 30	Interval: --	Occurrences: --	Comments:	HOLD Bevacizumab and notify provider for SBP GREATER than or EQUAL to 160 mmHg or DBP GREATER than or EQUAL to 100 mmHg
			Nursing Orders
  	ONC NURSING COMMUNICATION 32	Interval: --	Occurrences: --	Comments:	For patients of Cohort A, on Day 1 of each cycle, atezolizumab will be administered first, followed by bevacizumab, with a minimum of 5 minutes between dosing.
			Chemotherapy
  	INV-atezolizumab (ML44719/Pro00037831/Abdelrahim) 1,200 mg in sodium chloride 0.9% 250 mL (4.8 mg/mL) IVPB	Dose: 1,200 mg	Route: intravenous	once for 1 dose	Start: S			Instructions:	Prepared IV bag contains Atezolizumab 1200 mg in 250 mL 0.9% NaCl. Administer intravenously using a 0.2 micron inline filter over 60 minutes for initial infusion, and over 30 minutes of subsequent infusions if tolerated per protocol instructions. Stability of prepared dose: 6 hours at room temp or 24 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOL (ML44719/PRO00037831/ABDELRAHIM)	Medications	1,200 mg	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	230 mL	Yes	Yes			  	INV-BEVACIZUMAB (ML44719/PRO00037831/ABDELRAHIM) 15 mg/kg (Treatment Plan)	Dose: 15 mg/kg	Route: intravenous	once for 1 dose			Offset: 65 Minutes	Instructions:	Prepared IV bag contains Bevacizumab. Administer intravenously using a 0.2 micron inline filter over 90 minutes for initial infusion, and over 60 minutes for 2nd infusion, and over 30 minutes for subsequent infusions if tolerated per protocol instructions. Stability 8 hours refrigerated. 

Caution: New Drug - Limited by federal (USA) Law to investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	acetaminophen (TYLENOL) tablet 650 mg	Dose: 650 mg	Route: oral	once PRN	Start: S				  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
EOT	Repeat 1 time	Cycle length: 90 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 22	Interval: --	Occurrences: --	Comments:	Limited physical examination, and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 15	Interval: --	Occurrences: --	Comments:	Concomitant medications information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	ONC NURSING COMMUNICATION 16	Interval: --	Occurrences: --	Comments:	Adverse events information is to be collected and recorded on an ongoing basis throughout the study as well as at each visit.
		  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Temperature, pulse rate, respiratory rate, and systolic and diastolic blood pressure will be assessed.
Blood pressure and pulse measurements will be assessed seated position. Blood pressure and pulse measurements should be preceded by at least 5 minutes of rest for the participant in a quiet setting without distractions (e.g., television, cell phones).
Vital signs (to be taken before blood collection for laboratory tests) will consist of one pulse and three blood pressure measurements (three consecutive blood pressure readings will be recorded at intervals of at least 1 minute). The average of the three blood pressure readings will be recorded on the eCRF.
		  	MEASURE WEIGHT	Interval: --	Occurrences: --		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.
			Labs
  	TROPONIN	Interval: --	Occurrences: --	Comments:	o Perform ONLY at LabCorp, Quest, or HM ECC sites. 
o As clinically indicated.
		  	TROPONIN T	Interval: --	Occurrences: --	Comments:	As clinically indicated
		  	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	MAGNESIUM LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	LDH	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ALPHA FETOPROTEIN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	PROTHROMBIN TIME WITH INR	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	May be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
			Labs
  	HEPATITIS C ANTIBODY	Interval: --	Occurrences: --	Comments:	IF HCV antibody test is positive, perform HCV RNA.
					
Survival Follow UP	Repeat 1 time	Cycle length: 90 days	Day 1	Perform every 1 day x1			Research tolerance: -0/+0 days	Provider Communication
  	ONC PROVIDER COMMUNICATION	Interval: --	Occurrences: --	Comments:	Please refer to Study Protocol for any questions or discrepancies. See Schedule of Events Calendar for sequence of diagnostic tests, examinations, and treatment administration: See Safety Parameters-for Toxicity Management and Dose Modification Guidelines: Protocol Access hyperlink:    ML44719_Abdelrahim
			Nursing Orders
  	ONC NURSING COMMUNICATION 10	Interval: --	Occurrences: --	Comments:	ECOG Performance Status and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 11	Interval: --	Occurrences: --	Comments:	Child-Pugh scoring and local laboratory assessments may be obtained LESS than or EQUAL to 96 hours before or on Day 1 of each cycle.
		  	ONC NURSING COMMUNICATION 30	Interval: --	Occurrences: --	Comments:	Survival follow-up information will be collected via clinic visits, telemedicine visits, telephone calls, patient medical records, and/or clinic visits approximately every 3 months (± 21 days) until death, loss to follow-up, or until study termination by the Sponsor. All patients will be followed for survival and new anti-cancer therapy (including targeted therapy and immunotherapy) information unless the patient requests to be withdrawn from follow-up; this request must be documented in the source documents and signed by the investigator.
		  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	As clinically indicated
			Imaging
  	ONC NURSING COMMUNICATION 12	Interval: --	Occurrences: --	Comments:	o Tumor Scans performed within 6 weeks prior to the treatment discontinuation visit do not need to be repeated. 
o Survival FUP Not required for participants who experience disease progression.