avelumab at a glance
Medicine class
PD-L1 immune-checkpoint inhibitor
Licensed cancer types
Metastatic Merkel cell carcinoma, advanced urothelial carcinoma maintenance and advanced renal cell carcinoma
Administration
A diluted intravenous infusion given under specialist supervision
Important safety point
Immune-related effects may start during treatment or after it ends
What is avelumab used for?
Licensed uses in adults are:
Avelumab alone for metastatic Merkel cell carcinoma.
Avelumab alone as first-line maintenance treatment for locally advanced or metastatic urothelial carcinoma that has not progressed after platinum-based chemotherapy.
Avelumab with axitinib as first-line treatment for advanced renal cell carcinoma.
How does avelumab work?
Some tumour cells use PD-L1 to switch off cancer-fighting T cells. Avelumab binds PD-L1 and blocks its interaction with PD-1 and B7.1, restoring anti-tumour T-cell activity. Its IgG1 structure may also help natural-killer cells destroy antibody-coated tumour cells.
avelumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 20 mg/mL
How to take avelumab
Avelumab is prepared and given by trained staff as a diluted infusion into a vein. It must not be given as an intravenous push or bolus.
Paracetamol and an antihistamine are given before initial infusions to reduce infusion-related reactions; later premedication depends on clinical judgement.
Tell staff immediately about chills, flushing, dizziness, rash, wheezing, breathlessness, back pain or abdominal pain during the infusion.
Carry the supplied Patient Card and show it to healthcare professionals treating you.
avelumab side effects
Common or expected effects
- Tiredness
- Nausea or vomiting
- Diarrhoea or constipation
- Reduced appetite and weight loss
- Infusion-related reactions
- Anaemia
- Headache or dizziness
- Thyroid underactivity or overactivity
- With axitinib: high blood pressure, hoarse voice, cough and joint pain
Get urgent medical advice
- Severe infusion or allergic reaction
- Lung inflammation causing cough or breathlessness
- Hepatitis causing jaundice, dark urine or upper abdominal pain
- Colitis causing persistent diarrhoea, blood or mucus in stools, or severe abdominal pain
- Inflammation of the pancreas or heart
- Hormone-gland inflammation causing profound tiredness, faintness, headache, mood change or altered heartbeat
- New type 1 diabetes or diabetic ketoacidosis
- Kidney inflammation with reduced urine or swelling
- Severe blistering or peeling rash
- New muscle weakness, eye symptoms, swallowing difficulty or chest pain
avelumab in pregnancy
Human pregnancy information is limited. Because avelumab can cross the placenta and its mechanism may harm a pregnancy, it is not recommended unless a specialist considers it clinically necessary. People who could become pregnant should use effective contraception during treatment and for at least one month afterwards, and contact their specialist promptly if pregnancy occurs.
avelumab while breastfeeding
It is unknown whether avelumab enters human milk, and a risk to a breastfed child cannot be excluded. Avoid breastfeeding during treatment and for at least one month afterwards; discuss feeding options with the oncology and maternity teams.
avelumab interactions
Formal interaction studies have not been performed. Conventional pharmacokinetic interactions are not expected, but the specialist team should review all prescribed, non-prescribed and complementary products.
Axitinib
This combination has a greater risk of liver-enzyme elevation than avelumab alone, requiring more frequent liver monitoring and coordinated toxicity management.
Common questions about avelumab
Answers are fully visible for fast scanning and source review.
Is avelumab chemotherapy?
No. It is an immune-checkpoint inhibitor that helps immune cells attack cancer rather than directly damaging rapidly dividing cells like conventional chemotherapy.
Is avelumab always used with axitinib?
No. It is used alone for its licensed Merkel cell and urothelial carcinoma indications. Axitinib is used with it for advanced renal cell carcinoma.
Can side effects occur after treatment stops?
Yes. Immune-related inflammation can first appear after treatment ends, so report new or worsening symptoms promptly.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.