Reviewed by: HU Medical Review Board | Last reviewed: July 2022 | Last updated: July 2022
Imfinzi® (durvalumab) is an immunotherapy treatment, meaning it impacts the way the immune system functions. More specifically, it is a human monoclonal antibody that blocks the programmed death-ligand PD-L1.
It is indicated for use in adults patients with unresectable, stage III NSCLC (non-small cell lung cancer) that has not worsened after concurrent platinum-based chemotherapy and radiation therapy. Additionally, Imfinzi is indicated in combination with certain chemotherapy medications as a first-line treatment for people with extensive-stage small-cell lung cancer (ES-SCLC) who have not tried any other treatment options.
How does durvalumab work?
Durvalumab blocks a programmed death-ligand, PD-L1. PD-L1 is a protein that plays a key role in regulating the immune system and immune response. PD-L1 binds to a receptor called PD-1 on specific immune system cells, including T cells and B cells. These cells normally attack foreign invaders or mutated cells, such as cancers. When PD-L1 and PD-1 join together, the immune system response is inhibited, or turned down, significantly. When the immune system is turned down, the chance of immune cells like T cells finding and eliminating cancer cells is decreased. Cancer cells can take advantage of this and can increase PD-1 and PD-L1 binding to avoid the protective cells of the immune system. Durvalumab blocks the joining of PD-1 and PD-L1 to keep the immune response from being suppressed.
What are the possible side effects of durvalumab?
Multiple clinical trials evaluated the safety and effectiveness of durvalumab. The most common side effects of durvalumab for individuals receiving it for treatment of certain forms of lung cancer include fatigue, cough, lung inflammation, rash, problems breathing, upper respiratory infections, hair loss, and nausea. This is not an exhaustive list of all potential side effects of durvalumab. Talk to your healthcare provider or pharmacist for further information.
Factors to note about durvalumab
Durvalumab is an immunotherapy treatment that can impact the way the immune system functions, potentially leading to serious damage to other organs and tissues. Individuals taking durvalumab should be monitored for the following complications:
- Liver problems, including hepatitis
- Lung problems, including pneumonitis
- Intestinal problems, including colitis
- Hormone gland problems, including issues with the thyroid, pituitary, pancreas, and adrenals
- Kidney problems
- Skin problems
- Severe infusion reactions
It is also important to alert your doctor or healthcare provider if you notice any other new or worsening symptoms, including rash, confusion, mood, or behavior changes, muscle weakness or pain, chest pain, shortness of breath, or difficulties with vision. These symptoms could be indicative of an issue with another organ or organ system.
The above signs and symptoms are not exhaustive of all indicators of potential issues. Talk to your doctor or healthcare provider if you are concerned about any new or worsening symptoms, even beyond the list above. Durvalumab is indicated for use by adults only. It is not indicated for use by women who are pregnant or breastfeeding.
Durvalumab can cause harm to a developing fetus and should not be given to women who are pregnant. While receiving durvalumab, females who can become pregnant should use contraceptives during treatment and for a period of time after completing treatment (patients should discuss appropriate birth control methods, and how long they need to use them, with their doctor). Females should not breastfeed during durvalumab treatment and for a period of time following the final dose (patients should discuss breastfeeding considerations with their doctor).
Consult with your doctor
Before starting durvalumab, alert your provider if you:
- Have liver problems
- Have immune system problems including lupus, ulcerative colitis, or Crohn’s disease
- Have breathing or lung problems
- Have had an organ transplant
- Currently have or are currently being treated for an infection
- Are taking any other medications, including vitamins, over-the-counter medications, or herbal supplements
- Have any other medical conditions
- Are pregnant or could become pregnant
- Are breastfeeding
Receiving durvalumab treatment
Durvalumab is administered through an intravenous (IV) infusion into a vein. The exact dosage and number of treatments will be determined by your doctor. Any missed infusion appointments need to be rescheduled as soon as possible.
Individuals receiving durvalumab should be monitored for side effects, including pneumonitis (inflammation of the lungs), changes in liver function, intestinal problems, changes in kidney function, hormone changes, rashes, infections, and infusion-related reactions. Patients should talk to their doctor if they have any questions, or if they have questions regarding their durvalumab regimen.1