Avelumab (Bavencio) for the treatment of metastatic Merkel cell carcinoma


Avelumab (trade name: Bavencio) has been approved in Germany since September 2017 for the treatment of metastatic Merkel cell carcinoma in adults.

Merkel-cell carcinoma is a rare, aggressive form of skin cancer that mainly affects older people. It is most common on parts of the skin that are often exposed to sunlight, like the face. It leads to reddish-purple round bumps on the skin.

The tumor is surgically removed, if possible. But sometimes it has already become too large or spread to other parts of the body (metastasis). It is then called advanced or metastatic Merkel cell carcinoma.

The aim of treatment with avelumab is to stimulate the immune system to fight the cancer.


Avelumab is given as an infusion (IV drip), entering the bloodstream directly through a vein. The recommended dose is 800 mg. It is given over a period of 60 minutes every 14 days.

The treatment is stopped if the cancer progresses or if very severe side effects occur.

Other treatments

There is currently no other approved medication for the treatment of metastatic Merkel-cell carcinoma besides avelumab. So the treatment is individually adjusted by the doctor. Pembrolizumab or nivolumab can be used off-label for this purpose.


In 2020, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) tried to look into the advantages and disadvantages of avelumab when compared with the standard treatment for metastatic Merkel cell carcinoma in adults.

But the manufacturer didn’t provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of avelumab (Bavencio).

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Avelumab (metastatic Merkel cell carcinoma) – Benefit assessment according to §35a Social Code Book V. Dossier assessment; Commission A20-34. June 29, 2020. (IQWiG reports; Volume 936).

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on July 16, 2020
Next planned update: 2023


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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