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Avelumab Immunotherapy: Management of Adverse Events Associated With New Treatment for Merkel Cell Carcinoma

Heather Ugolini
Jennifer Bryan
Meliessa Hennessy
Howard L. Kaufman
Sandra P. D’Angelo
CJON 2019, 23(1), E1-E9 DOI: 10.1188/19.CJON.E1-E9

Background: Metastatic Merkel cell carcinoma (mMCC) is a rare skin cancer with poor prognosis. Avelumab is the first approved treatment option for patients with mMCC. Immune checkpoint inhibitors, such as avelumab, are associated with unique toxicities that can be effectively addressed with prompt recognition and appropriate management.

Objectives: This article discusses the use of avelumab for the treatment of mMCC and management of associated toxicities.

Methods: Literature on mMCC disease state and clinical trial data for avelumab were reviewed.

Findings: Avelumab has been investigated in patients with mMCC either following disease progression after one or more prior lines of chemotherapy or no prior systemic therapy. These patients experience clinically meaningful benefit. About 70% of patients receiving avelumab experience treatment-related adverse events. Given the limited benefit of chemotherapy, managing symptoms related to avelumab is key to administering this effective treatment to patients with mMCC.

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