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Avelumab

About Avelumab

Avelumab is a prescription medicine used to treat specific types of advanced cancers, such as Merkel cell carcinoma (a rare skin cancer) and cancers of the bladder or urinary tract. It is also used in combination with other prescription therapies to treat advanced kidney cancer. This medicine helps by empowering your body's immune system to recognise and fight cancer cells.

This medicine is given as an intravenous infusion by a healthcare professional on a regular schedule determined by your doctor. Because this is an injection directly into your vein, it can be given without regard to meals. To support your body during therapy, it is helpful to stay hydrated, eat a balanced diet, and get adequate rest.

While receiving Avelumab, you may experience common side effects like tiredness, muscle pain, nausea, or diarrhoea. However, because this medicine affects your immune system, it can sometimes cause your body to attack normal tissues, leading to serious problems. If you notice any unusual shortness of breath, yellowing of your skin or eyes, severe stomach pain, or new skin rashes, contact your healthcare provider immediately.

Do not take this if you have had a severe, life-threatening allergic reaction to this medicine in the past. Before starting, talk to your doctor if you have had an organ transplant, a history of lung or breathing problems, liver damage, or active autoimmune diseases like lupus or inflammatory bowel disease.

It is important to discuss all other medicines, supplements, or vaccines you are taking with your healthcare provider, as some can interfere with how this medicine works. Pregnant or breastfeeding women should not receive this medicine due to risks of harm to the baby, and elderly individuals should talk to their doctor to closely monitor their physical tolerance during therapy.

Uses of Avelumab

Avelumab is used in the treatment of Merkel cell carcinoma, Renal cell carcinoma and Urothelial carcinoma. The detailed uses of Avelumab are as follows: • Merkel cell carcinoma: Avelumab is used to treat metastatic Merkel cell carcinoma, a rare and aggressive form of skin cancer, in adults and children aged 12 years and older. • Urothelial carcinoma: Avelumab is used to treat locally advanced or metastatic urothelial carcinoma (a type of bladder or urinary tract cancer) in adults when the disease has progressed after platinum-based chemotherapy. • Renal cell carcinoma: Avelumab is used in combination with axitinib to treat advanced renal cell carcinoma (kidney cancer) that cannot be removed surgically or has spread to other parts of the body.

Medicinal Benefits

Avelumab helps your immune system recognise and fight advanced cancer cells, supporting disease control and improving treatment outcomes. The key benefits of Avelumab are as follows:

  • Supports the Immune System: By blocking the pathways that cancer cells use to hide from your body's natural defences, Avelumab helps your immune system work harder against advanced cancer cells, slows the spread of the disease, and can help shrink existing tumours.
  • Relieves Cancer-Related Symptoms: For many patients, tumour shrinkage can relieve physical pressure and pain caused by advanced cancer, leading to improved comfort and daily physical function.
  • Professionally Managed Treatment: Because the therapy is managed and given by healthcare professionals in a clinic, you do not have to worry about managing complex daily dosing schedules at home.

Directions for Use

  • Follow your doctor's instructions on the dosage and timing of this medication.
  • Avelumab will be administered by a doctor or nurse in a healthcare facility.
  • Do not self-administer.

Storage

Store in a cool and dry place away from sunlight

Side Effects of Avelumab

Common Side Effects (Usually mild):

  • Feeling very tired or weak
  • Nausea, diarrhoea, or decreased appetite
  • Muscle, bone, or joint pain
  • Mild skin rash or itching
     

Serious Side Effects (Consult your doctor right away):

  • Signs of lung problems, such as a new or worsening cough, chest pain, or shortness of breath
  • Signs of liver damage, including yellow skin or eyes, dark urine, or severe right-sided stomach pain
  • Severe bowel issues, including intense stomach pain, fever, or bloody diarrhoea
  • Infusion reactions during or shortly after the injection, such as shaking, chills, fever, dizziness, or flushing
  • Hormonal changes, such as extreme fatigue, rapid heart rate, unexplained weight changes, or deep voice changes

Drug Warnings

  • Check the Medicine Before Infusion: Before each session, confirm with your nurse that the medicine vial has been inspected and is clear, colourless, and free of visible particles.
  • Report Infusion Reactions Immediately: Tell your clinical team immediately if you feel warm, dizzy, itchy, or have trouble breathing while the infusion is entering your vein.
  • Carry a Medical Alert Card: Carry a medical alert card at all times indicating that you are receiving immunotherapy, so emergency medical personnel are aware.
  • Avoid Live Vaccines: Do not receive any live vaccines during your treatment without discussing them with your doctor first.
  • Use Effective Contraception: Use highly effective birth control during your treatment and for at least one month after your final dose to prevent pregnancy.

Drug Interactions

  • Systemic Corticosteroids: Medicines like prednisone can suppress your immune system, which may reduce the effectiveness of Avelumab if taken before starting treatment. However, your doctor may use them to treat serious side effects once you are on therapy.

Drug-Drug Interactions Checker List:

  • THALIDOMIDE
  • PREDNISOLONE
  • PREDNISONE
  • METHYLPREDNISOLONE
  • Safety Advice

    • Safety Warning

      Alcohol

      consult your doctor

      It is unknown whether Avelumab interacts with alcohol. Consult your doctor for more information.

    • Safety Warning

      Pregnancy

      unsafe

      Avelumab is not recommended for use in pregnancy as it may cause embryo-fetal toxicity and harm your foetus. Hence, if you are pregnant or planning pregnancy, inform your doctor before receiving Avelumab. You should not become pregnant while you are receiving Avelumab for at least one month from the last dose of Avelumab. Using effective birth control methods while on treatment is suggested.

    • Safety Warning

      Breast Feeding

      unsafe

      Avelumab should not be taken if you are breastfeeding as it passes into breast milk and may harm your infant. Avoid nursing your child while on treatment with this medicine and for at least one month from the last dose of medicine.

    • Safety Warning

      Driving

      not applicable

      Avelumab will be administered to hospitalized patients.

    • Safety Warning

      Liver

      caution

      If you have a pre-existing or a history of liver problems, tell your doctor before receiving this medicine. Inform your doctor if you experience any symptoms, such as severe nausea or vomiting, right-sided upper stomach pain, easy bruising or bleeding, dark urine, or jaundice (yellowing of the skin or eyes). Your doctor may suggest tests to monitor your liver function while on treatment with this medicine.

    • Safety Warning

      Kidney

      caution

      If you have a pre-existing or a history of kidney diseases, inform your doctor before receiving Avelumab. Tell your doctor if you have little or no urination, swelling in your feet or ankles, or blood in your urine. Your doctor may adjust the dose of this medicine or prescribe a suitable alternative based on your condition.

    • Safety Warning

      Children

      unsafe

      Avelumab is not recommended for use in children below 12 years as the safety and efficacy are not established.

    Habit Forming

    No

    Diet & Lifestyle Advise

    • Stay Hydrated: Drink plenty of fluids, especially water, on the days surrounding your infusion to help support your kidneys and stay hydrated.
    • Eat Small, Bland Meals: Eat small, frequent, and bland meals (like crackers, rice, or oatmeal) if you experience mild nausea or stomach upset.
    • Protect Your Skin: Protect your skin from sun exposure by wearing long sleeves, a wide-brimmed hat, and broad-spectrum sunscreen, as immunotherapy can make your skin more sensitive to light.
    • Balance Rest and Activity: Balance your daily activities with plenty of rest to help manage treatment-related fatigue.
    • Avoid Exposure to Infections: Avoid close contact with people who have active, contagious infections to protect your system while undergoing cancer treatment.

    Special Advise

    • Your doctor may suggest periodic liver function tests, kidney function tests, and lung function tests to monitor the function of the liver, kidney and lungs due to the use of Avelumab.
    • Using contraceptive pills while using Avelumab to prevent pregnancy is advised.
    • Thyroid function and adrenocorticotropic hormone levels will be monitored during treatment to avoid any life-threatening side effects.

    Patients Concern

    Disease/Condition Glossary

    Renal Cell Carcinoma: It is the most common type of cancer in which cancer/ malignant cells grow uncontrollably in the kidney and form a tumor. Symptoms include red, orange, or pink-coloured urine due to the presence of blood in the urine.

    Bladder cancer: It is a cancer that begins in the bladder. It typically affects older adults. The most common symptom is blood in the urine.

    Merkel Cell Carcinoma: Also known as neuroendocrine carcinoma of the skin. It is a type of skin cancer in which the cancer cells develop out of control in the epidermis (the outermost layer of the skin).

    FAQs

    Avelumab is used to treat Merkel cell carcinoma, Renal cell carcinoma and Urothelial carcinoma.

    Avelumab contains Avelumab, which works by inhibiting the action of a programmed death receptor-1 (PD-L1) that causes the multiplication of cancerous cells.

    Avelumab is given as an intravenous (IV) infusion directly into a vein by a doctor or nurse in a clinical setting. The process usually takes about an hour. Talk to your doctor to learn more about the setup.

    No, you should not receive this medicine during pregnancy as it can harm an unborn baby. Use effective birth control during treatment and for at least one month after your final dose. Talk to your doctor if you have questions about family planning.

    Mild skin rashes can happen, but a severe rash can be a sign of a serious immune response. Report any skin redness, itching, or blistering to your medical team right away. Talk to your doctor or pharmacist for guidance.

    There is no direct chemical interaction between alcohol and Avelumab. However, drinking alcohol can worsen fatigue, nausea, or dehydration. Talk to your doctor or pharmacist before drinking alcohol during your treatment cycle.

    Your doctor will determine how long you stay on the treatment based on how well your tumour responds and how well your body tolerates the medicine. Talk to your doctor about your specific treatment schedule.

    The most common side effects are fatigue, muscle and joint pain, nausea, and diarrhoea. Most of these can be managed, but you should keep your clinical team informed of all symptoms. Talk to your doctor or pharmacist if these side effects become hard to manage.

    Yes, it can cause immune-mediated lung inflammation, which can be serious. Call your healthcare provider immediately if you experience a new or worsening cough, shortness of breath, or chest pain. Talk to your doctor if you have any breathing concerns.

    Your healthcare provider will usually give you premedicines, like allergy medicines and fever reducers, before your first few infusions to reduce the risk of a reaction. Talk to your doctor about what to expect before your first session.

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