Avelumab

Avelumab Brand Name– BAVENCIO

What is Avelumab

Avelumab is a human IgG1 lambda monoclonal antibody that binds to the programmed death ligand-1 (PD-L1) found on T-cells and blocks the interaction of PD-L1 with PD-1 and B7.1 receptors on the tumor cell.

It is indicated for the treatment of metastatic Merkel cell carcinoma, advanced renal cell carcinoma, and certain types of urothelial carcinoma.

Immune-mediated adverse reactions including colitis, pneumonitis, hepatitis, endocrinopathies, and nephritis have been reported with avelumab therapy in clinical trials; treatment with high-dose corticosteroids may be necessary for patients who develop immune-mediated toxicity.

Indications

  • Merkel cell carcinoma
  • renal cell cancer
  • urothelial carcinoma

Side Effects

  1. abdominal pain
  2. acneiform rash
  3. adrenocortical insufficiency
  4. anemia
  5. anorexia
  6. antibody formation
  7. arthralgia
  8. arthralgia
  9. asthenia
  10. back pain
  11. bone pain
  12. bullous rash
  13. chills
  14. colitis
  15. constipation
  16. cough
  17. cystitis
  18. dehydration
  19. diabetes mellitus
  20. diabetic ketoacidosis
  21. diarrhea
  22. dizziness
  23. dysphonia
  24. dyspnea
  25. elevated hepatic enzymes
  26. erythema
  27. erythema multiforme
  28. exfoliative dermatitis
  29. fatigue
  30. fever
  31. flushing
  32. GI obstruction
  33. Guillain-Barre syndrome
  34. headache
  35. heart failure
  36. hematuria
  37. hepatitis
  38. hepatotoxicity
  39. hyperamylasemia
  40. hyperbilirubinemia
  41. hypercholesterolemia
  42. hyperglycemia
  43. hyperkalemia
  44. hypertension
  45. hyperthyroidism
  46. hypertriglyceridemia
  47. hyponatremia
  48. hypophysitis
  49. hypopituitarism
  50. hypotension
  51. hypothyroidism
  52. ileus
  53. infection
  54. infusion-related reactions
  55. interstitial nephritis
  56. lymphopenia
  57. maculopapular rash
  58. malaise
  59. musculoskeletal pain
  60. myalgia
  61. myocardial infarction
  62. myocarditis
  63. nausea
  64. neutropenia
  65. palmar-plantar erythrodysesthesia (hand and foot syndrome)
  66. pancreatitis
  67. pericardial effusion
  68. peripheral edema
  69. pneumonitis
  70. pruritus
  71. psoriasis
  72. pyuria
  73. rash
  74. renal failure (unspecified)
  75. stomatitis
  76. thrombocytopenia
  77. thromboembolism
  78. uveitis
  79. vomiting
  80. weight loss

Monitoring Parameters

  • blood glucose
  • LFTs
  • serum creatinine
  • thyroid function tests (TFTs)

Contraindications

  • adrenal insufficiency
  • autoimmune disease
  • breast-feeding
  • cardiac disease
  • colitis
  • contraception requirements
  • diabetes mellitus
  • diabetic ketoacidosis
  • heart failure
  • hepatic disease
  • hepatitis
  • hepatotoxicity
  • hyperlipidemia
  • hypertension
  • hyperthyroidism
  • hypothyroidism
  • immune-mediated reactions
  • immunosuppression
  • infusion-related reactions
  • myocardial infarction
  • organ transplant
  • pneumonitis
  • pregnancy
  • renal impairment
  • reproductive risk
  • thyroid disease
  • type 1 diabetes mellitus

Interactions

  • Palifermin
  • Penicillamine
  • Tuberculin Purified Protein Derivative, PPD
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