阿维鲁单抗(Avelumab)的不良反应和副作用

Avelumab, as a PD-L1 inhibitor, is an important tumor immunotherapy option. Understanding the potential side effects of the drug facilitates timely management.

Side effects of avelumab that require immediate medical attention

In addition to its therapeutic effects, avelumab may cause adverse reactions. These side effects are not inevitable, but if serious symptoms occur, you need to seek medical attention immediately:

1. Common side effects

Back pain; abdominal distention or swelling of the face, arms, hands, calves, or feet; chest tightness; vision problems; chills; Clay-colored stools; confusion; constipation; cough; dark-colored urine; decreased appetite; depressed mood; dizziness, fainting, or lightheadedness when standing up suddenly from a lying or sitting position; dry skin and hair; feeling warm or cold; fever; hair loss; headache; hives or welts , itching, or rash; hoarseness; irritation; joint pain, stiffness, or swelling; muscle spasms and stiffness; nausea; nervousness; ringing in the ears; rapid weight gain; redness of the face, neck, arms, and occasionally upper chest; redness, swelling, or pain of the skin ; Flaky skin on hands and feet; slow or fast heartbeat; stomach pain; sweating; swelling of eyelids, face, lips, hands, or feet; tingling in hands or feet; trouble breathing or swallowing; skin ulcers; unusual tiredness or weakness; unusual weight gain or loss; vomiting; yellow eyes or skin.

2. Less common side effects

Hematuria; chest pain; frequent urination or decreased urine output; general malaise or feeling of illness; abnormal thirst; pain in the lower back or flank; pain in the chest/groin/lower limbs (especially the calf); Sudden severe headache; speech dysfunction; sneezing; sore throat; abdominal cramps; sudden ataxia; sudden severe weakness or abnormal sensation in unilateral limbs; edema of face/fingers/lower limbs; sticky respiratory secretions; abnormal vision; watery or bloody stools.

3. Rare side effects

Skin blistering, peeling or loosening; chest discomfort; cloudy urine; skin pigmentation; speech dysfunction; double vision; drowsiness; dry mouth; ketosis breath odor (fruity breath); limb or facial motor dysfunction; loss of function Speech; hyperappetite; polyuria; indigestion; anorexia; disturbance of consciousness; myalgia; abdominal pain (which may radiate to the back); purple-red skin rash; conjunctival congestion; heat intolerance; delayed speech; oral mucosal ulcers or white spots; lymphadenopathy; lethargy; unexplained weight loss; right upper quadrant pain.

Side effects of avelumab that require immediate consultation with a doctor

Mild adverse reactions that usually do not require medical intervention may occur during drug treatment. These symptoms tend to gradually alleviate as the body adapts to the drug. If persistent or bothersome symptoms occur, it is recommended to consult the attending physician in time:

Bone pain; chapped lips; weight loss; difficulty moving; voice changes.

Avelumab’s side effects for medical personnel’s reference

1. Cardiovascular adverse events

(1) Very common (10% or more): hypotension (25%), hypertension (13%).

(2) Uncommon (0.1% to 1%): myocarditis.

2. Skin diseases

(1) Very common (10% or more): urticaria (25%), rash (such as maculopapular rash, erythema, bullous dermatitis) (22%), pruritus (10%).

(2) Uncommon (0.1% to 1%): psoriasis, arthritis, exfoliative dermatitis, pemphigoid, Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), histiocytic necrotizing lymphadenitis, vasculitis, hypophysitis.

3. Endocrine glands

(1) Common (1%-10%): immune-mediated thyroid disease (hypothyroidism/hyperthyroidism)

(2) Uncommon (0.1%-1%): adrenal insufficiency, hypopituitarism, hypophysitis.

4. Gastrointestinal reactions

(1) Very common (10% or more): abdominal pain (25%), diarrhea (23%), nausea (22%), constipation (17%).

(2) Common (1%-10%): immune-mediated colitis.

(3) Uncommon (0.1% to 1%): pancreatitis.

5. Blood system

(1) Very common (10% or more): lymphopenia (49%), anemia (35%), thrombocytopenia (27%).

(2) Common (1%-10%): neutropenia.

(3) Rare (0.01%-0.1%): Hemolytic anemia.

6. Hepatotoxicity

(1) Very common (10% or more): elevated aspartate aminotransferase (AST) (34%), elevated alanine aminotransferase (ALT) (20%).

(2) Common (1%-10%): elevated bilirubin

(3) Uncommon (0.1%-1%): immune-mediated hepatitis.

7. Immune system

Common (1%-10%): immunogenicity.

8. Localized

(1) Very common (10% or more): anorexia (20%), weight loss (15%), increased lipase (14%)

(2) Common (1% to 10%): increased amylase.

9. Metabolism

(1) Very common (10% or more): anorexia (20%), weight loss (15%), increased lipase (14%)

(2) Common (1% to 10%): increased amylase.

10. Musculoskeletal

(1) Very common (10% or more): musculoskeletal pain (32%), back pain (25%), joint pain (16%).

(2) Uncommon (0.1%-1%): myositis, rhabdomyolysis, myasthenia gravis.

11. Nervous system

(1) Very common (10% or more): dizziness (14%), headache (10%).

(2) Uncommon (0.1%-1%): Guillain-Barre syndrome, demyelination, encephalitis.

12. Respiratory system

(1) Very common (10% or more): Couth (18%), dyspnea (11%).

(2) Common (1%-10%): immune-mediated pneumonia and wheezing.

13. Nephrotoxicity

Rare (less than 0.1%): immune-mediated nephritis.

14. Ocular toxicity

Uncommon (0.1% to 1%): uveitis, iritis.

15. Others

Very common (10% or more): fatigue (50%), fever (25%), chills (25%), flushing (25%), peripheral edema (20%).