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Bavencio (avelumab)

Bavencio® (avelumab) is a type of immunotherapy. It is used to treat Merkel cell carcinoma that has spread to distant parts of the body (metastasized).1

Bavencio does not come in generic form. Bavencio is also approved to treat bladder cancer.

How does Bavencio work?

Bavencio can be described as an “immune checkpoint inhibitor” or “anti-PD-L1 therapy.” It is thought to work in two ways. First, Bavencio prevents cancer cells from hiding from your immune system’s T-cells. Second, it is thought to attract your body’s defense cells to destroy the cancer cell.

Prevents cancer cells from hiding

T-cells (T-lymphocytes) are a type of white blood cell.2 T-cells fight cancer and infection. They travel through the body, checking whether the cells they find are normal (healthy) or foreign (unhealthy). Receptors on the outside surface, called PD-1 and B7.1, do the checking. PD-1 stands for “programmed death receptor-1.”

Cancer cells try to hide from T-cells. They have proteins called PD-L1 on their outside surface. PD-LI stands for “programmed death ligand-1.” When PD-L1 binds (connects) to PD-1, it basically acts like an “off switch” for the T-cell. This makes the T-cell ignore the cancer cell.

Bavencio binds to PD-L1.1 This blocks PD-L1 from interacting with its receptors (PD-1 or B7.1), disabling the “off switch.” The T-cell is able to identify and attack the cancer cell.

Attracts defense cells to destroy the cancer cell

Foreign (unhealthy) cells have proteins, called antigens, on their cell surface. Your body responds to these foreign antigens by making antibodies. The antibodies do many things. One thing they do is activate your body’s defense cells, which work together to destroy the unhealthy cell.3

Laboratory studies have shown that Bavencio activates this system.1 Bavencio is a type of medication called an “IgG monoclonal antibody.” It may work by “flagging” the cancer cell as a target for your body’s natural defense cells.

How effective is Bavencio?

Bavencio was studied in 88 patients with metastatic Merkel cell carcinoma that progressed after chemotherapy.1,4 One third of patients (33%) had a response to treatment. “Response” has to do with whether the tumor shrinks or grows more slowly while on treatment. Response is only about tumor changes and it does not measure whether you—as a whole patient—have improved. Response is also different from survival. Response to treatment can be partial or complete. In this study, 11.4% of patients had a complete response and 21.6% had a partial response.1

The response lasted at least 6 months in 86% of responders. It lasted for a year or more in 45%.1 This study is still ongoing. More results, including survival outcomes, should be coming.5

How is Bavencio given?

Before receiving Bavencio, read the Medication Guide that comes in the package. Talk to your doctor about how often and how many treatments you will need.

Bavencio is taken through an intravenous (IV) line. Your doctor will administer Bavencio. Bavencio is usually given every 2 weeks. It takes about 60 minutes to administer the medication.

What are the side effects of Bavencio?

The most common side effects of Bavencio are:1

  • Feeling tired
  • Muscle and bone pain
  • Diarrhea
  • Nausea
  • Swelling in your hands, feet, or ankles
  • Loss of appetite
  • Skin rash

Bavencio can cause your immune system to attack normal (healthy) organs and tissue. Rare but serious possible side effects are:

  • Lung inflammation (pneumonitis)
  • Liver inflammation (hepatitis)
  • Intestinal inflammation (colitis)
  • Problems with hormone glands (thyroid, adrenal, pancreas)
  • Kidney inflammation
  • Other problems (severe muscle weakness, severe or lasting muscle or joint pain, chest pain or tightness, trouble breathing, skin reaction, changes in heartbeat, tiredness, swelling of the feet and legs, dizziness or fainting, fever, flu-like symptoms, changes in eyesight)

Bavencio is infused (put) into your vein through an IV line. Severe, life-threatening infusion reactions can occur. Symptoms include chills, shaking, hives, flushing, shortness of breath, wheezing, low blood pressure, fever, back pain, or abdominal pain.1

Who should not take Bavencio?

Bavencio can harm an unborn baby.1 Women who could become pregnant should use birth control during treatment and for at least 1 month after the last dose of Bavencio. Do not breastfeed while taking Bavencio or for 1 month after the last dose.

Tell your doctor about any medical conditions you have, especially:

  • Immune system problems (such as Crohn’s disease, ulcerative colitis, lupus).
  • Previous organ transplant.
  • Lung or breathing problems.
  • Liver or kidney problems.
  • Diabetes.

What precautions are needed when taking Bavencio?

You will need regular blood tests to check for side effects of Bavencio. Your doctor may prescribe corticosteroids or hormone replacement medicines to treat certain side effects.1

During treatment and for at least 1 month after the last dose of Bavencio:1

  • Women who can become pregnant should use birth control.
  • Women should not breastfeed.
Written by: Sarah O'Brien | Last reviewed: October 2018.
  1. Bavencio® [prescribing information]. Whitehouse Station, NJ: Merck & Co, Inc; May 2017.
  2. PubMed Health. T-Lymphocytes (T-Cells). Accessed April 7, 2017 at:
  3. PubMed Health. The defense mechanism of the adaptive immune system. Accessed April 9, 2017 at:
  4. Kaufman HL, Russell J, Hamid O, et al. Avelumab in patients with chemotherapy-refractory metastatic Merkel cell carcinoma: a multicentre, single-group, open-label, phase 2 trial. Lancet Oncol. 2016;17:1374-1385.
  5. Avelumab in subjects with Merkel cell carcinoma (JAVELIN Merkel 200). NCT02155647. Accessed April 10, 2017 at: