Name of the Procedure:

Injection, avelumab, 10 mg (HCPCS code J9023)

Summary

Avelumab injection is a medical treatment where a specific cancer-fighting drug, avelumab, is administered directly into the bloodstream. This procedure is commonly used in the management of certain advanced cancers.

Purpose

Avelumab is used to treat various types of cancer by targeting and inhibiting proteins that allow cancer cells to grow unchecked. The primary goal is to reduce the size of tumors, slow disease progression, and improve patient survival rates.

Indications

• Merkel cell carcinoma
• Advanced or metastatic urothelial carcinoma
• Other advanced cancers as determined by an oncologist

Patients suitable for this procedure typically have cancers that have not responded to standard treatments or are ineligible for other forms of cancer therapy.

Preparation

• No specific fasting required, but patients should follow their oncologist’s instructions.
• Blood tests and imaging studies may be conducted to assess overall health and disease status.
• Patients should inform the healthcare team about any medications they are taking, including over-the-counter drugs and supplements.

Procedure Description

1. The patient is comfortably seated or lying down.
2. A healthcare professional inserts an intravenous (IV) line, usually into a vein in the arm.
3. The prescribed dose of avelumab (10 mg) is prepared and administered through the IV line.
4. The infusion typically takes about 60 minutes to complete.
5. The IV line is removed once the infusion is finished.

Equipment: IV line, infusion pump, avelumab solution

No anesthesia or sedation is typically required for this procedure.

Duration

The infusion usually takes approximately 60 minutes. Additional time may be needed for preparation and post-infusion monitoring.

Setting

This procedure is generally performed in an outpatient clinic or hospital infusion center.

Personnel

• Oncologist
• Oncology nurse
• Pharmacist (for drug preparation)

Risks and Complications

• Common: Injection site reactions, fatigue, nausea, decreased appetite
• Rare: Severe infusion reactions, immune-related side effects (e.g., inflammation of organs), and infection Complication management includes immediate medical attention, potential administration of corticosteroids, or other supportive treatments.

Benefits

Expected benefits include tumor shrinkage and slow cancer progression. Improvements might be noticed within a few weeks to months, depending on the individual's response to the treatment.

Recovery

• Patients can usually go home shortly after the infusion.
• It's advisable to have a companion for transportation, especially if feeling unwell after the procedure.
• Routine follow-up appointments for monitoring response and side effects.
• Patients might experience fatigue and should rest as needed.

Alternatives

• Surgery
• Radiation therapy
• Other chemotherapy or immunotherapy drugs

Each alternative has its own pros and cons. Surgery may offer immediate removal of the tumor, while other drugs might be less effective or have different side effect profiles compared to avelumab.

Patient Experience

During the procedure, patients may feel a mild discomfort when the IV is inserted. Some patients might experience mild side effects, such as fatigue or nausea, which temporary measures and medications can manage. Following the procedure, patients should communicate any new or worsening symptoms to their healthcare team promptly.