Drug Action
Avelumab is a monoclonal antibody, which binds to the programmed death-1 (PD-1) receptor, thereby potentiating an immune response to tumour cells.
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Drug reference
Avelumab is a monoclonal antibody, which binds to the programmed death-1 (PD-1) receptor, thereby potentiating an immune response to tumour cells.
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Metastatic Merkel cell carcinoma (specialist use only) ▶BY INTRAVENOUS INFUSION ▶Adult: 10 mg/kg every 2 weeks, for information on dose delay or interruption due to side-effects and infusion- related reactions—consult product literature
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Patients should receive pre-medication to minimise the development of adverse reactions (consult product literature)
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NICE decisions ▶Avelumab for treating metastatic Merkel cell carcinoma (April 2018) NICE TA517 Avelumab is recommended as an option for treating metastatic Merkel cell carcinoma in adults, only if they have had 1 or more lines of chemotherapy for metastatic disease. Avelumab is recommended for use within the Cancer Drugs Fund as an option for treating metastatic Merkel cell carcinoma in adults, only if: . they have not had chemotherapy for metastatic disease, and . the conditions in the managed access agreement for avelumab are followed. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta517 Scottish Medicines Consortium (SMC) decisions SMC No. 1315/18 The Scottish Medicines Consortium has advised (May 2018) that avelumab (Bavencio ®) is accepted for use within NHS Scotland as monotherapy for treating adults with metastatic Merkel cell carcinoma.
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→Appendix 1: monoclonal antibodies
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▶Common or very common Abdominal pain. anaemia. appetite decreased. arthralgia. asthenia. back pain. chills . constipation. cough. diarrhoea. dizziness. dry mouth. dyspnoea. fever. headache. hypertension. hypotension. hypothyroidism. influenza like illness. infusion related reaction. lymphopenia. myalgia. nausea. nerve disorders . peripheral oedema. pneumonitis. skin reactions. vomiting. weight decreased ▶Uncommon Adrenal insufficiency. diabetes mellitus. eosinophilia. flushing. gastrointestinal disorders. hepatic disorders. hypersensitivity. hyperthyroidism. hypopituitarism. myositis. nephritis. systemic inflammatory response syndrome. thrombocytopenia. thyroiditis. uveitis ▶Rare or very rare Myocarditis. pancreatitis ▶Frequency not known Endocrine disorders SIDE-EFFECTS, FURTHER INFORMATION Infusion-related For treatment modifications in patients with reactions grade 1 or 2 infusion-related reactions, consult product literature. Manufacturer advises permanently discontinue treatment in patients with grade 3 or 4 infusion-related reaction. Immune-related reactions Most immune-related adverse reactions are reversible and managed by temporarily stopping treatment and administration of a corticosteroid—consult product literature for further information.
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Manufacturer advises women of child-bearing potential should use effective contraception during treatment and for at least 1 month after stopping treatment.
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Manufacturer advises avoid unless essential—no information available. See also Pregnancy and reproductive function in Cytotoxic drugs p. 938.
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Manufacturer advises avoid during treatment and for at least 1 month after stopping treatment—no information available.
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Manufacturer advises monitor for signs and symptoms of infusion- and immune- related reactions.
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Manufacturer advises for intermittent intravenous infusion (Bavencio ®), dilute requisite dose with Sodium Chloride 0.9%; give over 60 minutes via a separate line using a low-protein binding 0.2 micron filter. l HANDLING AND STORAGE Manufacturer advises store in a refrigerator (2–8 °C)—consult product literature for storage conditions after preparation of the infusion.
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There can be variation in the licensing of different medicines containing the same drug. Solution for infusion ▶Bavencio (Merck Serono Ltd) A Avelumab 20 mg per 1 ml Bavencio 200mg/10ml concentrate for solution for infusion vials | 1 vial P £768.00
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10 mg/kg every 2 weeks, for information on dose
First-line fragment. Read the complete Indications and Dose section above.
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