Durvalumab

(Imfinzi®)

Durvalumab

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Drug updated on 5/17/2024

Dosage FormInjection (intravenous; 500 mg/10 mL [50 mg/mL], 120 mg/2.4 mL [50 mg/mL])
Drug ClassProgrammed death-ligand 1 blocking antibodies
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of adult patients with unresectable, Stage III non-small cell lung cancer (NSCLC) whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy.
  • Indicated in combination with etoposide and either carboplatin or cisplatin, as first-line treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC).
  • Indicated in combination with tremelimumab-actl and platinum-based chemotherapy, for the treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) with no sensitizing epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) genomic tumor aberrations.
  • Indicated in combination with gemcitabine and cisplatin, as treatment of adult patients with locally advanced or metastatic biliary tract cancer (BTC).
  • Indicated in combination with tremelimumab-actl, for the treatment of adult patients with unresectable hepatocellular carcinoma (uHCC).

Summary
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  • Durvalumab (Imfinzi) is indicated for the treatment of adult patients with various types of lung cancer and biliary tract cancer, as well as unresectable hepatocellular carcinoma. It can be used alone or in combination with other drugs such as etoposide, carboplatin, cisplatin, tremelimumab-actl, and gemcitabine.
  • A total of 20 studies were reviewed to gather information about durvalumab's effectiveness and safety compared to other therapeutic options like nivolumab, pembrolizumab, atezolizumab, and immune checkpoint inhibitors combined with chemotherapies.
  • In terms of hepatocellular carcinoma (HCC) with PVTT treatment outcomes, HAIC-FO combined with sorafenib showed more favorable results than combinations involving durvalumab.
  • For Stage III Unresectable NSCLC patients who have undergone concurrent platinum-based chemotherapy and radiation therapy without disease progression, post-treatment use of durvalumab is associated with significant improvement in 1-year overall survival rates (OS) and progression-free survival rates (PFS).
  • When treating extensive-stage small cell lung cancer (ES-SCLC), although effective when used alongside chemotherapy, durvalumab was found less beneficial than serplulimab regarding OS & PFS benefits, positioning it as a viable but not the most effective option within this indication.
  • Durvalumab has shown promising potential when paired with gemcitabine for advanced BTC treatments by offering a balance between tolerability and enhanced survival outcomes.
  • In real-world scenarios involving the stage III NSCLC patient population, durvalumab demonstrated similar safety and efficacy profiles to those observed during clinical trials, despite the inclusion of a broader patient population, thus highlighting its practical applicability.
  • The incidence of adverse events across indications, especially among elderly patients or those with compromised performance status, emphasizes the importance of monitoring and managing potential toxicities while using the drug.

Product Monograph / Prescribing Information

Document TitleYearSource
Imfinzi (durvalumab) Prescribing Information.2023AstraZeneca Pharmaceuticals LP., Wilmington, DE

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Comparative efficacy and safety of multimodality treatment for advanced hepatocellular carcinoma with portal vein tumor thrombus: patient-level network meta-analysis.2024Frontiers in Oncology
Efficacy and safety of consolidation durvalumab after chemoradiation therapy for stage III non-small-cell lung cancer: a systematic review, meta-analysis, and meta-regression of real-world studies.2023Frontiers in Pharmacology
Efficacy and safety of first-line immunotherapy plus chemotherapy in treating patients with extensive-stage small cell lung cancer: a bayesian network meta-analysis.2023Frontiers in Immunology
First-line systemic treatment for hepatocellular carcinoma: a systematic review and network meta-analysis.2023Heliyon
Efficacy and safety of immune checkpoint inhibitors combined with chemotherapy in patients with extensive-stage small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials.2023Frontiers in Oncology
Real-world safety and efficacy of consolidation durvalumab after chemoradiation therapy for stage III non-small cell lung cancer: a systematic review and meta-analysis.2022International Journal of Radiation Oncology, Biology, Physics
Comparison of different first-line systemic therapies in advanced biliary tract cancer based on updated random controlled trials: a systematic review and network meta-analysis.2022BioMed Research International
Addition of immune checkpoint inhibitors to chemotherapy vs chemotherapy alone as first-line treatment in extensive-stage small-cell lung carcinoma: a systematic review and meta-analysis. 2022Oncology and Therapy
Impact of PD1 and PDL1 immunotherapy on non-small cell lung cancer outcomes: a systematic review.2022Thorax
Comparative efficacy and safety of immunotherapeutic regimens with PD-1/PD-L1 inhibitors for previously untreated extensive-stage small cell lung cancer: a systematic review and network meta-analysis.2021Current Oncology
Meta-analysis of immune-related adverse events in phase 3 clinical trials assessing immune checkpoint inhibitors for lung cancer.2021Clinical Reviews in Oncology/Hematology
Immune checkpoint inhibitors for treatment of small-cell lung cancer: a systematic review and meta-analysis.2021Annals of Translational Medicine
The relationship between blood-based tumor mutation burden level and efficacy of PD-1/PD-L1 inhibitors in advanced non-small cell lung cancer: a systematic review and meta-analysis. 2021BMC Cancer
Comparison of atezolizumab, durvalumab, pembrolizumab, and nivolumab as first-line treatment in patients with extensive-stage small cell lung cancer: a systematic review and network meta-analysis.2021Medicine
Systematic review and network meta-analysis of immune checkpoint inhibitors in combination with chemotherapy as a first-line therapy for extensive-stage small cell carcinoma.2020Cancers
Durvalumab and tremelimumab combination therapy versus durvalumab or tremelimumab monotherapy for patients with solid tumors: a systematic review and meta-analysis.2020Medicine Open
Efficacy and safety of first-line immunotherapy in combination with chemotherapy for patients with extensive-stage small cell lung cancer: a systematic review and network meta-analysis.2020Journal of Oncology
Association of PD-L1 expression status with the efficacy of PD-1/PD-L1 inhibitors and overall survival in solid tumours: a systematic review and meta-analysis.2020International Journal of Cancer
Efficacy and safety of immune checkpoint inhibitors in patients with advanced non-small cell lung cancer (NSCLC): a systematic literature review.2020Oncoimmunilogy
The differences in the safety and tolerability of immune checkpoint inhibitors as treatment for non-small cell lung cancer and melanoma: network meta-analysis and systematic review.2019Frontiers in Pharmacology

Clinical Practice Guidelines