durvalumab at a glance
Medicine class
PD-L1 immune checkpoint inhibitor monoclonal antibody
Administration
Given by intravenous infusion in a hospital or clinic
Main roles
Licensed for selected lung, biliary tract, liver, endometrial, bladder, gastric and gastro-oesophageal junction cancers
Key safety issue
Immune-related inflammation can affect almost any organ and requires prompt assessment
What is durvalumab used for?
Durvalumab is licensed for selected adult cancer settings, including:
Locally advanced, unresectable non-small cell lung cancer with qualifying PD-L1 expression when disease has not progressed after platinum-based chemoradiation.
Resectable non-small cell lung cancer meeting specified tumour-size or nodal criteria, without known EGFR mutations or ALK rearrangements.
Limited-stage or extensive-stage small cell lung cancer in specified settings.
Locally advanced, unresectable or metastatic biliary tract cancer.
Advanced or unresectable hepatocellular carcinoma.
Primary advanced or recurrent endometrial cancer.
Resectable muscle-invasive bladder cancer.
Resectable gastric or gastro-oesophageal junction adenocarcinoma.
How does durvalumab work?
PD-L1 on tumour and immune cells can suppress T-cell activity. Durvalumab binds PD-L1 and blocks these signals, helping T cells recognise and attack cancer cells.
durvalumab preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 50 mg/mL
How to take durvalumab
Durvalumab is prepared and given by healthcare professionals as a diluted infusion into a vein. It is not taken by mouth, so food does not affect its administration.
The infusion is given in a hospital or clinic under specialist supervision.
Tell staff immediately about chills, flushing, itching, rash, dizziness, wheezing or breathlessness during the infusion.
durvalumab side effects
Common or expected effects
- Cough
- Diarrhoea or abdominal pain
- Rash or itching
- Fever
- Joint pain
- Underactive thyroid
- Upper respiratory infection
- With chemotherapy: tiredness, nausea, constipation, reduced appetite, hair loss and low blood-cell counts
Get urgent medical advice
- Lung inflammation: new or worsening cough, breathlessness or chest pain
- Bowel inflammation: severe, persistent or bloody diarrhoea or severe abdominal pain
- Liver inflammation: jaundice, dark urine, right-sided abdominal pain or unusual bruising
- Hormone-gland inflammation: severe fatigue, persistent headache, dizziness, major weight change or excessive thirst and urination
- Kidney inflammation: substantially reduced urine
- Heart, nerve, brain, eye or muscle inflammation: chest pain, irregular heartbeat, weakness, confusion, seizures, vision changes or severe muscle symptoms
- Severe skin or infusion reactions, including blistering, wheezing, faintness or facial swelling
durvalumab in pregnancy
Durvalumab is not recommended during pregnancy because it may harm the fetus. Effective contraception is required during treatment and for at least three months after the final administration. Discuss pregnancy or plans to conceive promptly with the oncology team.
durvalumab while breastfeeding
It is unknown whether durvalumab enters human milk or could harm a breastfed child. The specialist team should weigh the benefit of breastfeeding against the benefit of treatment and decide whether breastfeeding or durvalumab should be withheld.
durvalumab interactions
Formal pharmacokinetic interaction studies are limited, although metabolic interactions are not expected. Tell the oncology team about all prescribed, non-prescription and herbal products.
Systemic corticosteroids and other immunosuppressants
Use before starting durvalumab may reduce its immune activity. They may nevertheless be needed to control immune-related toxicity after treatment begins.
Live attenuated vaccines
Evidence around treatment is limited, so agree vaccination type and timing with the oncology team.
Common questions about durvalumab
Answers are fully visible for fast scanning and source review.
Is durvalumab chemotherapy?
No. It is an immune checkpoint inhibitor, although some licensed uses combine it with chemotherapy.
Does tumour testing affect whether durvalumab is suitable?
Yes. PD-L1 testing is required for its locally advanced NSCLC indication, and mismatch-repair testing determines maintenance treatment in endometrial cancer.
Can side effects occur after treatment stops?
Yes. Immune-related effects can begin or persist after treatment, so report new symptoms to the oncology team.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.