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Avelumab


Thông tin thuốc gốc
Chỉ định và Liều dùng
Intravenous
Locally advanced urothelial carcinoma, Metastatic urothelial carcinoma
Adult: As maintenance treatment of cases that has not progressed with 1st-line platinum-containing chemotherapy; in patients who have disease progression during or following platinum-containing chemotherapy or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-based chemotherapy: 800 mg via IV infusion over 60 minutes once every 2 weeks. Continue treatment until disease progression or unacceptable toxicity occurs. Premedicate with antihistamine and paracetamol prior to the 1st 4 infusions. Dosing interruption or discontinuation may be required according to individual safety and tolerability (refer to detailed product guideline).

Intravenous
Advanced renal cell carcinoma
Adult: In combination with axitinib: 800 mg via IV infusion over 60 minutes once every 2 weeks. Continue treatment until disease progression or unacceptable toxicity occurs. Premedicate with antihistamine and paracetamol prior to the 1st 4 infusions. Dosing interruption or discontinuation may be required according to individual safety and tolerability (refer to detailed product guideline).

Intravenous
Metastatic Merkel cell carcinoma
Adult: 800 mg via IV infusion over 60 minutes once every 2 weeks. Continue treatment until disease progression or unacceptable toxicity occurs. Premedicate with antihistamine and paracetamol prior to the 1st 4 infusions. Dosing interruption or discontinuation may be required according to individual safety and tolerability (refer to detailed product guideline).
Hướng dẫn pha thuốc
IV infusion: Withdraw the required volume from the vial then transfer to an infusion bag containing 250 mL of NaCl 0.9% or NaCl 0.45% solution. Mix by gentle inversion. Do not shake.
Thận trọng
Patient with myasthenia gravis. Patients who received allogeneic haematopoietic cell transplant before or after treatment with an anti-programmed-death ligand-1 (PD-L1) or programmed cell death-1 (PD-1) monoclonal antibody. Pregnancy. Discontinue breastfeeding during therapy and for at least 1 month after the last dose.
Tác dụng không mong muốn
Significant: Immune-mediated reactions including endocrinopathies (e.g. adrenal insufficiency, diabetes mellitus including diabetic ketoacidosis, hypophysitis, thyroid disorders), dermatologic toxicity (e.g. exfoliative dermatitis including Stevens-Johnson syndrome, drug rash with eosinophilia and systemic symptoms, toxic epidermal necrolysis), colitis, uveitis, iritis, other ocular inflammatory toxicities, nephritis with kidney dysfunction.
Blood and lymphatic system disorders: Anaemia, lymphopenia, thrombocytopenia.
Gastrointestinal disorders: Nausea, diarrhoea, vomiting, constipation, abdominal pain, dry mouth.
General disorders and administration site conditions: Fatigue, pyrexia, peripheral oedema, asthenia, chills, influenza-like illness.
Investigations: Decreased weight; increased blood creatinine, alkaline phosphatase, lipase, GGT or amylase.
Metabolism and nutrition disorders: Decreased appetite, hyponatraemia.
Musculoskeletal and connective tissue disorders: Back pain, arthralgia, myalgia.
Nervous system disorders: Headache, dizziness, peripheral neuropathy.
Respiratory, thoracic and mediastinal disorders: Cough, dyspnoea.
Skin and subcutaneous tissue disorders: Rash, pruritus, dry skin, maculopapular rash.
Vascular disorders: Hypertension.
Potentially Fatal: Immune-mediated reactions including cardiovascular events (e.g. myocarditis, pericarditis, vasculitis), hepatitis, pancreatitis, pneumonitis, meningitis, encephalitis, myelitis and demyelination, myasthenic syndrome, myasthenia gravis (including exacerbation), cystitis, sarcoidosis, Guillain-Barre syndrome, myositis or polymyositis; infusion-related reactions.
Thông tin tư vấn bệnh nhân
Women of childbearing potential must use proven birth control methods during therapy and for at least 1 month after the last dose. This drug may cause fatigue, if affected, do not drive or operate machinery.
Chỉ số theo dõi
Monitor LFTs (e.g. AST, ALT, total bilirubin), kidney function (e.g. creatinine) and thyroid function tests (at baseline, periodically thereafter during treatment and as clinically indicated); blood glucose (for hyperglycaemia). Assess for signs and symptoms of infusion-related reactions and immune-mediated adverse effects.
Tác dụng
Description:
Mechanism of Action: Avelumab is an IgG1 lambda immunoglobulin and a human anti-programmed-death ligand-1 monoclonal antibody antineoplastic agent. It binds to programmed death ligand 1 (PD-L1) to selectively inhibit the interaction between the programmed cell death-1 (PD-1), a negative immunoregulatory protein, and B7.1 receptors. This eliminates the suppressive effects of PD-L1 on cytotoxic CD8+ T-cells, leading to the restoration of anti-tumour T-cell responses. Additionally, it has been shown to promote natural killer cell-mediated tumour cell lysis through antibody-dependent cell-mediated cytotoxicity.
Pharmacokinetics:
Absorption: Time to peak plasma concentration: Within 1 hour.
Distribution: Crosses the placenta.
Metabolism: Metabolised via proteolytic degradation.
Excretion: Elimination half-life: 6.1 days.
Bảo quản
Intact vial: Store between 2-8°C. Do not freeze. Protect from light. Diluted solution: Store at room temperature for up to 4 hours or between 2-8°C for up to 24 hours. Do not freeze.
Phân loại MIMS
Liệu pháp miễn dịch trong điều trị ung thư
Phân loại ATC
L01FF04 - avelumab ; Belongs to the class of PD-1/PD-L1 (Programmed cell death protein 1/death ligand 1) inhibitors. Used in the treatment of cancer.
Tài liệu tham khảo
Avelumab. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com. Accessed 10/03/2025.

Avelumab. UpToDate Lexidrug, AHFS DI (Adult and Pediatric) Online. American Society of Health-System Pharmacists, Inc. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 10/03/2025.

Avelumab. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 10/03/2025.

Bavencio 20 mg/mL Concentrate for Solution for Infusion (Merck Serono Ltd). MHRA. https://products.mhra.gov.uk. Accessed 10/03/2025.

Bavencio 200 mg/10 mL Concentrate for Solution for Infusion (Merck Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 10/03/2025.

Bavencio Injection, Solution, Concentrate (EMD Serono, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/03/2025.

Brayfield A, Cadart C (eds). Avelumab. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/03/2025.

Joint Formulary Committee. Avelumab. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/03/2025.

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