Bavencio

Indications

Avelumab is a prescription cancer medicine. It is used to treat metastatic Merkel cell carcinoma (a rare, aggressive skin cancer), as maintenance treatment for advanced urothelial (bladder and urinary tract) cancer that has not worsened after platinum-based chemotherapy, and together with Axitinib for advanced kidney cancer (renal cell carcinoma). Treatment is decided by a cancer specialist.

How It Works

Avelumab is a monoclonal antibody, a laboratory-made protein that targets one specific molecule. It blocks PD-L1, a protein that cancer cells use to switch off the immune system's T cells. By blocking it, Avelumab helps the immune system recognise and attack cancer cells. This type of treatment is called immunotherapy or an immune checkpoint inhibitor.

Dosage and Administration

Avelumab is given as an infusion into a vein (drip) over about 1 hour by a doctor or nurse in a hospital or cancer centre, usually every 2 weeks. The dose and how long treatment continues are set by the specialist. Medicines such as an antihistamine and Paracetamol are usually given before the first infusions to reduce infusion reactions.

Interactions

No formal interaction studies are known. Tell your doctor about all medicines, especially steroids or other medicines that suppress the immune system, as these may reduce its effect if used before treatment starts. When used with Axitinib, liver and blood pressure problems may be more common.

Contraindications

Do not use if you have had a severe allergic reaction to Avelumab or any ingredient of the product.

Side Effects

• Tiredness, nausea, diarrhoea, reduced appetite and weight loss
• Infusion reactions: fever, chills, flushing, back pain, low blood pressure or breathing difficulty during or soon after the drip
• Rash and itching
• Immune-related inflammation of organs: lungs (pneumonitis), bowel (colitis), liver (hepatitis), hormone glands (thyroid, adrenal, pituitary), kidneys, and new-onset diabetes

Get urgent medical help if you have new or worsening cough or shortness of breath, severe diarrhoea or blood in the stools, yellow skin or eyes, severe tiredness, extreme thirst or passing a lot of urine, confusion, chest pain, or signs of a severe allergic reaction. These immune side effects can appear even months after treatment ends.

Pregnancy and Lactation

Avelumab may harm an unborn baby and should not be used in pregnancy unless the specialist decides it is essential. Women who could become pregnant should use effective contraception during treatment and for at least 1 month after the last dose. Do not breastfeed during treatment and for at least 1 month after the last dose.

Precautions and Warnings

• Tell your doctor if you have an autoimmune disease, have had an organ transplant, or have lung, liver, kidney or hormone problems.
• Regular blood tests for liver, kidney, thyroid and sugar levels are needed.
• Carry a patient alert card and tell any doctor you see that you are on immunotherapy.
• Report new symptoms early; side effects are often treated with steroids and pausing treatment.

Overdose

Avelumab is given by health professionals, so overdose is unlikely. If it happens, the patient is watched closely for side effects and treated as needed.

Therapeutic Class

Antineoplastic monoclonal antibody (PD-L1 immune checkpoint inhibitor).

Storage

Hospital medicine. Store as directed on the pack, in a refrigerator at 2 to 8°C; do not freeze or shake. Keep in the original carton to protect from light.