What is Avelumab: Uses, Dosage, Side Effects and More

Avelumab is a targeted cancer treatment that helps your immune system fight certain types of cancer more effectively. It's a type of immunotherapy medication called a monoclonal antibody that blocks proteins that prevent your immune system from attacking cancer cells.

This medication is given through an IV infusion at a cancer treatment center or hospital. Your healthcare team will carefully monitor you during and after each treatment to ensure your safety and comfort.

What is Avelumab?

Avelumab is a prescription immunotherapy drug that works by removing the brakes on your immune system. It belongs to a class of medications called PD-L1 inhibitors, which means it blocks a protein that cancer cells use to hide from your body's natural defenses.

Unlike traditional chemotherapy that directly attacks cancer cells, avelumab helps your own immune system recognize and destroy cancer cells. Think of it as giving your immune system better tools to do its job of protecting your body from harmful cells.

The medication is manufactured as a liquid solution that must be diluted before being given through an intravenous line. Healthcare professionals handle all the preparation and administration to ensure proper dosing and safety.

What is Avelumab Used For?

Avelumab is approved to treat several specific types of cancer where other treatments haven't worked or aren't suitable. Your oncologist will determine if this medication is right for your particular situation based on your cancer type and medical history.

The most common uses include treating advanced bladder cancer that has spread to other parts of the body. It's specifically used when the cancer has continued growing after chemotherapy or when chemotherapy isn't a good option for you.

Avelumab is also used for a rare skin cancer called Merkel cell carcinoma. This aggressive cancer often responds well to immunotherapy treatments like avelumab, especially when it has spread beyond the original tumor site.

Additionally, it may be used in combination with other medications to treat certain types of kidney cancer. Your cancer care team will explain exactly why this medication is being recommended for your specific diagnosis.

How Does Avelumab Work?

Avelumab works by targeting a specific protein called PD-L1 that sits on the surface of cancer cells. This protein acts like a disguise that tricks your immune system into leaving the cancer cells alone.

When avelumab blocks PD-L1, it removes this disguise and allows your immune system's T-cells to recognize the cancer as foreign. Once your immune system can see the cancer clearly, it can attack and destroy these harmful cells more effectively.

This is considered a moderately strong cancer treatment that can produce significant responses in some patients. However, it works differently than traditional chemotherapy and may take several weeks or months to show its full effects.

The medication continues working in your system even between treatments. This ongoing immune activation is why some people experience delayed responses or continue improving weeks after starting treatment.

How Should I Take Avelumab?

Avelumab is always given by healthcare professionals through an intravenous infusion in a medical facility. You cannot take this medication at home, and it requires careful preparation and monitoring by trained staff.

The infusion typically takes about 60 minutes to complete. Your healthcare team will insert an IV line into your arm or central line if you have one, then slowly administer the diluted medication.

You'll usually receive treatment every two weeks, though your doctor may adjust this schedule based on how you respond and any side effects you experience. It's important to keep all your scheduled appointments even if you're feeling well.

Before each infusion, you'll likely receive medications to help prevent allergic reactions. These pre-medications, often including antihistamines and sometimes steroids, help reduce the risk of infusion-related side effects.

You don't need to eat any special foods before treatment, but staying well-hydrated is helpful. Some people find it easier to eat a light meal a few hours before their appointment rather than coming on an empty stomach.

How Long Should I Take Avelumab For?

The duration of avelumab treatment varies significantly from person to person and depends on how well your cancer responds to the medication. Some people continue treatment for many months or even years if it's working well and side effects are manageable.

Your oncologist will regularly monitor your progress through imaging scans, blood tests, and physical examinations. These check-ups help determine whether the treatment is shrinking your cancer or preventing it from growing.

Treatment typically continues as long as your cancer is responding and you're not experiencing severe side effects. If your cancer starts growing again or if side effects become too difficult to manage, your doctor will discuss other treatment options.

Some people may need to take breaks from treatment if they develop certain side effects. These treatment holidays allow your body to recover while often maintaining the beneficial effects of the immunotherapy.

What Are the Side Effects of Avelumab?

Like all cancer treatments, avelumab can cause side effects, though not everyone experiences them. The side effects happen because the medication activates your immune system, which can sometimes affect healthy parts of your body too.

Most people experience some side effects, but many are manageable with proper medical care and support. Your healthcare team will monitor you closely and provide treatments to help minimize discomfort when side effects occur.

Here are the most common side effects you might experience:

• Fatigue or feeling more tired than usual
• Muscle or joint pain
• Nausea or decreased appetite
• Skin rash or itching
• Diarrhea or constipation
• Infusion reactions like fever or chills during treatment

These common side effects are usually mild to moderate and often improve as your body adjusts to the treatment. Your medical team can provide medications and strategies to help manage these symptoms effectively.

More serious but less common side effects can affect various organs when your immune system becomes overactive. While these are concerning, they're usually reversible with prompt medical attention:

• Lung inflammation causing shortness of breath or persistent cough
• Liver problems that might cause yellowing of skin or eyes
• Thyroid gland changes affecting energy levels and metabolism
• Severe skin reactions or widespread rashes
• Kidney problems that might cause changes in urination
• Intestinal inflammation causing severe diarrhea or abdominal pain

These immune-related side effects require immediate medical attention and often need treatment with steroids or other medications to calm down your immune system. Most people recover fully when these side effects are caught and treated early.

Who Should Not Take Avelumab?

Avelumab isn't suitable for everyone, and your oncologist will carefully review your medical history before recommending this treatment. Certain health conditions or medications can make avelumab unsafe or less effective.

You shouldn't receive avelumab if you've had a severe allergic reaction to this medication or any of its ingredients in the past. Signs of serious allergic reactions include difficulty breathing, severe swelling, or widespread skin reactions.

People with active autoimmune diseases like lupus, rheumatoid arthritis, or inflammatory bowel disease may not be good candidates for avelumab. Since this medication stimulates your immune system, it could worsen these conditions.

If you're taking high doses of steroids or other medications that suppress your immune system, avelumab might not work as effectively. Your doctor will need to carefully balance these medications if immunotherapy is still the best option for you.

Pregnancy and breastfeeding are also important considerations. Avelumab could harm an unborn baby, so reliable birth control is essential during treatment and for several months afterward if you could become pregnant.

Avelumab Brand Names

Avelumab is sold under the brand name Bavencio in the United States and many other countries. This is the only brand name currently available for this medication.

Bavencio is manufactured by Pfizer and Merck KGaA, and it's the same formulation worldwide. You might see slightly different packaging or labeling in different countries, but the active ingredient and strength remain consistent.

Unlike some medications that have multiple brand names or generic versions, avelumab is only available as Bavencio. This helps ensure consistency in dosing and quality across different treatment centers.

Avelumab Alternatives

Several other immunotherapy medications work similarly to avelumab by targeting the PD-1 or PD-L1 pathway. Your oncologist might consider these alternatives if avelumab isn't suitable for you or if your cancer doesn't respond well to it.

Pembrolizumab (Keytruda) and nivolumab (Opdivo) are two commonly used alternatives that block the PD-1 protein instead of PD-L1. These medications often work in similar types of cancer and may be options if avelumab isn't available or appropriate.

Atezolizumab (Tecentriq) and durvalumab (Imfinzi) are other PD-L1 inhibitors like avelumab. These medications work through the same mechanism but may be approved for different types of cancer or used in different combinations.

The choice between these medications depends on factors like your specific cancer type, previous treatments, and individual health factors. Your oncologist will explain why one particular immunotherapy is recommended over others for your situation.

Is Avelumab Better Than Pembrolizumab?

Both avelumab and pembrolizumab are effective immunotherapy treatments, but they're not directly comparable since they're usually used for different types of cancer. Each medication has been studied and approved for specific cancer types where it shows the best results.

Avelumab targets PD-L1 on cancer cells, while pembrolizumab targets PD-1 on immune cells. Both approaches achieve similar results by allowing your immune system to attack cancer more effectively, but the specific mechanism is slightly different.

The choice between these medications depends more on your cancer type and stage than on one being universally better than the other. Your oncologist will recommend the immunotherapy that has the best evidence for treating your specific diagnosis.

In some cases, your doctor might switch from one to another if the first treatment stops working or causes too many side effects. This flexibility allows your treatment team to optimize your care based on your individual response.