Bavencio (avelumab) is a programmed death ligand-1 (PD-L1)-blocking antibody. It activates the human immune system to attack tumor cells, but may also trigger a series of immune-related adverse reactions.

What Are the Side Effects of Bavencio (Avelumab)?

Common Side Effects in Patients with Merkel Cell Carcinoma.

Fatigue and weakness.

Musculoskeletal pain.

Infusion-related reactions (e.g., fever, chills, back pain).

Rash.

Nausea, constipation, diarrhea.

Cough.

Common Side Effects in Patients with Urothelial Carcinoma

When used as maintenance therapy: Fatigue, musculoskeletal pain, urinary tract infection, rash.

In patients with recurrence after previous treatment: Fatigue, infusion-related reactions, musculoskeletal pain, nausea, decreased appetite, urinary tract infection.

Common Side Effects in Patients with Renal Cell Carcinoma (in combination with axitinib)

Diarrhea, fatigue, hypertension.

Musculoskeletal pain, nausea, oral mucositis.

Hand-foot skin reaction (palmar-plantar erythrodysesthesia).

Hoarseness, decreased appetite, hypothyroidism.

Rash, hepatotoxicity, cough, dyspnea, abdominal pain, headache.

Severe Side Effects of Bavencio (Avelumab) That Require Vigilance

Immune-Mediated Pneumonitis

Symptoms: New or worsening cough, chest pain, dyspnea.

Management: Suspend or permanently discontinue the drug based on severity, and administer corticosteroids for treatment.

Immune-Mediated Colitis

Symptoms: Diarrhea, bloody stools, mucoid stools, severe abdominal pain.

Management: Infection must be ruled out; for severe cases, suspend the drug and administer corticosteroids.

Immune-Mediated Hepatitis

Symptoms: Jaundice, darkening of urine, nausea and vomiting, right upper abdominal pain, bleeding tendency.

Management: Monitor liver enzymes; for severe cases, discontinue the drug and administer corticosteroids.

Immune-Mediated Endocrine Disorders

Includes thyroid dysfunction, adrenal insufficiency, hypophysitis, type 1 diabetes mellitus, etc.

Symptoms: Fatigue, weight changes, palpitations, excessive sweating, blurred vision, polydipsia and polyuria, etc.

Management: Administer hormone replacement therapy as appropriate; suspend the drug if necessary.

Precautions for Using Bavencio (Avelumab)

Pre-Treatment Assessment and Monitoring

Baseline tests: Include liver function, renal function, thyroid function, electrocardiogram (ECG), etc.

Regular rechecks: The above indicators must be monitored regularly during treatment to detect abnormalities early.

Concomitant Medications and Immune Status

Before use, inform the doctor if you have autoimmune diseases, a history of organ transplantation, a history of stem cell transplantation, etc.

Concomitant use of immunosuppressants may affect efficacy and increase the risk of infection.

Drug Storage and Preparation

Store at 2°C–8°C, protect from light; do not freeze or shake.

After preparation, use within 4 hours (at room temperature) or 24 hours (under refrigeration).

A 0.2-micron protein-binding filter must be used during infusion; do not share the infusion line with other drugs.