Avelumab

Avelumab is a human monoclonal antibody that targets programmed death-ligand 1 (PD-L1). It belongs to the class of immune checkpoint inhibitors and is marketed under the brand name Bavencio. The antibody is designed to block the interaction of PD-L1 with its receptors PD-1 and CD80, aiming to restore T-cell–mediated immune responses against cancer cells. As an IgG1 antibody, avelumab can also mediate antibody-dependent cellular cytotoxicity against PD-L1–expressing tumor cells.

Mechanism of action information: By inhibiting PD-L1 signaling, avelumab releases inhibitory brakes on the immune system, promoting anti-tumor activity. Its IgG1 nature allows potential engagement of immune effector mechanisms in addition to checkpoint blockade.

Clinical use and indications: Avelumab has been approved in several countries for metastatic Merkel cell carcinoma. It is also approved for advanced or metastatic urothelial carcinoma, including as maintenance therapy after platinum-based chemotherapy in eligible patients, with regulatory status varying by region. The drug has been studied in other tumor types and in combination regimens, such as renal cell carcinoma in combination with axitinib, with approvals and clinical use differing by jurisdiction.

Administration: The medicine is given by intravenous infusion at a dose of 10 mg/kg every two weeks, continued until disease progression or unacceptable toxicity is observed.

Safety and adverse effects: Common adverse effects include fatigue, infusion-related reactions, nausea, and decreased appetite. Immunotherapy-related adverse events may occur, affecting the colon, liver, lungs, endocrine glands, and other organs; management may involve monitoring and, when necessary, immunosuppressive treatment such as corticosteroids.

History: Avelumab was developed by Merck Serono and later brought to market as Bavencio. It has been evaluated in the JAVELIN clinical program, which supported its approvals for Merkel cell carcinoma and urothelial carcinoma in various regions.