Avelumab (Bavencio) is a programmed death ligand-1 (PD-L1) blocking antibody that activates the patient's own immune system to attack tumor cells.

Precautions for the Administration of Avelumab (Bavencio)

Target Population and Dosage

Merkel Cell Carcinoma (MCC): For adults and adolescents aged 12 years and older, the dose is 800 mg, administered as an intravenous infusion once every 2 weeks.

Urothelial Carcinoma (UC): When used as maintenance therapy or for treatment after the failure of previous platinum-based chemotherapy, the dosage is the same as above.

Renal Cell Carcinoma (RCC): When used in combination with axitinib, the dose of avelumab is 800 mg once every 2 weeks, and axitinib is administered orally at 5 mg twice daily.

Pretreatment Before Medication

To prevent infusion-related reactions, pretreatment with antihistamines and acetaminophen should be administered before the first 4 infusions. Subsequent pretreatment decisions should be based on the patient's response.

Administration Method

Intravenous infusion should be given over 60 minutes using a sterile, low-protein-binding 0.2-micron in-line filter.

The same infusion line must not be shared with other drugs.

The diluted solution should be used within 4 hours (at room temperature) or 24 hours (under refrigeration). Freezing and shaking should be avoided.

Infusion-Related Reactions

Some patients may experience reactions such as fever, chills, dyspnea, and hypotension.

For mild to moderate reactions, the infusion rate can be slowed down or the infusion can be interrupted. For severe or life-threatening reactions, permanent discontinuation of the drug is required.

Cardiovascular Events

When used in combination with axitinib, the risk of severe cardiovascular events (such as myocardial infarction and heart failure) may increase. Patients should seek medical attention immediately if they experience symptoms such as chest pain, dyspnea, or lower extremity edema.

For grade 3-4 events, the combined treatment regimen must be discontinued.

Transplantation-Related Complications

Patients who have previously received or plan to receive allogeneic hematopoietic stem cell transplantation may experience severe complications such as graft-versus-host disease, which requires close monitoring.

Monitoring During the Administration of Avelumab (Bavencio)

Baseline Examination and Regular Monitoring

Baseline examination: Includes liver function, renal function, thyroid function, and complete blood count.

Regular monitoring: The above indicators should be rechecked regularly during treatment to detect immune-related adverse reactions in a timely manner.

Cardiac monitoring: When treated in combination with axitinib, left ventricular ejection fraction should be evaluated regularly to monitor cardiovascular events.

Symptom Monitoring and Patient Education

Patients should be aware of the following symptoms and report them promptly: persistent cough, chest pain, and dyspnea.

Severe diarrhea, abdominal pain, and bloody stools.

Jaundice, darkening of urine color, and fatigue.

Palpitations, excessive sweating, weight changes, and mood abnormalities.

Skin rash, blisters, and oral or genital ulcers.

Decreased urine output and edema.