Imfinzi
Imfinzi (durvalumab) is a type of immunotherapy called an immune checkpoint inhibitor. It's used to treat a variety of cancers, such as certain types of lung cancer, liver cancer, bile duct cancer, and endometrial cancer. Imfinzi (durvalumab) is often given along with other immunotherapy or chemotherapy medications. Imfinzi (durvalumab) is infused into the veins by a trained member on your oncology team. It's usually given every 2 to 4 weeks, depending on the type of cancer. Imfinzi (durvalumab) can cause rare, but serious immune-related side effects including rash, breathing problems, and diarrhea.
What is Imfinzi (durvalumab)?
What is Imfinzi (durvalumab) used for?
Non-small cell lung cancer (NSCLC):
NSCLC that can be removed by surgery (with chemotherapy before surgery, or alone after surgery)
NSCLC that can't be removed by surgery (after platinum-based chemotherapy and radiation)
Metastatic NSCLC without EGFR or ALK mutations (with Imjudo (tremelimumab) and platinum-based chemotherapy)
Extensive-stage small cell lung cancer (SCLC) (with platinum-based chemotherapy)
Locally advanced or metastatic biliary tract cancer (with gemcitabine (Gemzar) and cisplatin (Platinol))
Advanced liver cancer (with Imjudo (tremelimumab))
Advanced endometrial cancer (with certain chemotherapy medications)
How Imfinzi (durvalumab) works
Your immune system acts as a defense system for the body, attacking bacteria, viruses, and cancer cells. Many healthy cells in your body have a special protein called PD-L1 that stops the immune system from attacking them. Usually cancer cells and other foreign cells don’t have this special protein. But some cancers have PD-L1 and they use it to hide from the immune system in order to grow and spread.
Imfinzi (durvalumab) is an immune checkpoint inhibitor (a type of immunotherapy). It works by blocking PD-L1 so that the immune system to can detect and attack the cancer cells.
Drug Facts
What are the side effects of Imfinzi (durvalumab)?
Common Side Effects
- Higher blood sugar levels (52%)
- Lower blood calcium levels (46%)
- Lower white blood cell counts (43%)
- Cough (40%)
- Higher liver lab tests (up to 39%)
- Trouble breathing and symptoms of lung inflammation (34%)
- Feeling very tired (34%)
- Lower blood sodium levels (33%)
- Higher blood potassium levels (32%)
- Sore throat, runny nose, and other symptoms of colds and sinus infections (26%)
- Trouble catching your breath (25%)
- Rash (23%)
Other Side Effects
- Diarrhea
- Lung infection
- Fever
- Stomach pain
Serious Side Effects
- Immune-related adverse events: diarrhea, stomach pain or cramps, blood or mucus in stool, rash, cough, trouble breathing
- Infusion-related reactions: shortness of breath, itching, chills, flushing, chest discomfort
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dry cough, shortness of breath or trouble breathing
- Eye pain, redness, irritation, or discharge with blurry or decreased vision
- Heart muscle inflammation—unusual weakness or fatigue, shortness of breath, chest pain, fast or irregular heartbeat, dizziness, swelling of the ankles, feet, or hands
- Hormone gland problems—headache, sensitivity to light, unusual weakness or fatigue, dizziness, fast or irregular heartbeat, increased sensitivity to cold or heat, excessive sweating, constipation, hair loss, increased thirst or amount of urine, tremors or shaking, irritability
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
- Kidney injury (glomerulonephritis)—decrease in the amount of urine, red or dark brown urine, foamy or bubbly urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pain, tingling, or numbness in the hands or feet, muscle weakness, change in vision, confusion or trouble speaking, loss of balance or coordination, trouble walking, seizures
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Sudden or severe stomach pain, bloody diarrhea, fever, nausea, vomiting
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Bone, joint, or muscle pain
- Diarrhea
- Fatigue
- Loss of appetite
- Nausea
- Skin rash
Pros and cons of Imfinzi (durvalumab)
Pros
Possible treatment option for various cancers, including NSCLC, biliary tract cancer, and liver cancer
Lasts a long time in the body, so only need one infusion every 3-4 weeks
Uses your own immune system to attack the cancer
Cons
Commonly causes fatigue and rash
Can cause rare but serious immune-related side effects
Might require additional treatment to manage immune-related side effects
Pharmacist tips for Imfinzi (durvalumab)
Imfinzi (durvalumab) can cause immune-related side effects due to an overactive immune system. Keep track of any new symptoms and let your oncology team know if you have new or worsening shortness of breath, rash, or diarrhea. Usually, these side effects can be managed with medications to help with your symptoms or lower inflammation. Your oncologist might pause your Imfinzi (durvalumab) treatment if your symptoms are severe.
Immune-related side effects can happen at any time and anywhere in the body. Be sure to do blood tests as recommended by your oncologist, so they can check if you have any signs of immune-related side effects that you might not feel.
Fatigue is a common side effect of cancer treatments, including Imfinzi (durvalumab). Do your best to remain active, eat well, and rest when you’re tired. You might need to rearrange your daily routine to make sure you have energy for important activities.
Imfinzi (durvalumab) hasn’t been studied in people who are pregnant or breastfeeding. But based on animal studies, it’s likely to harm an unborn baby and be transferred through breast milk. You should use effective birth control while taking Imfinzi (durvalumab) and for 3 months after stopping the medication. Avoid breastfeeding while taking Imfinzi (durvalumab) and for 3 months after stopping.
Frequently asked questions about Imfinzi (durvalumab)
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What are the risks and warnings for Imfinzi (durvalumab)?
Imfinzi (durvalumab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Immune-related adverse events
Risk factors: Prior radiation to the chest
Imfinzi (durvalumab) works by taking the “brakes” off the immune system to help the immune system better attack cancer cells. But sometimes, the immune system becomes too active, leading to rare but serious immune-related side effects. These side effects can happen at any time during Imfinzi (durvalumab) treatment, including after you stop the medication. In studies, these side effects appeared most frequently in the lungs, gut, liver, skin, and thyroid, but they can happen anywhere in the body. Your healthcare team will do blood tests to make sure that your organs are working well. Let an oncology team know if you notice any new or worsening shortness of breath, diarrhea, or rash, which could be signs of serious immune-related side effects.
Getting treatment for immune-related side effects quickly is key to preventing serious or irreversible damage. It’s likely that your oncologist will pause additional Imfinzi (durvalumab) treatment while managing the side effects. They might also recommend medications like steroids to lower the inflammation caused by the overactive immune system.
Infusion-related reactions
Some people had reactions to the Imfinzi (durvalumab) infusion, which in rare situations were life-threatening. During your Imfinzi (durvalumab) infusion, if you notice new chills, flushing, trouble breathing, itching, or dizziness, let your care team know right away. Those could be signs of an infusion reaction. Your care team will pause the infusion and manage your symptoms. Once your symptoms resolve, your team might restart your infusion at a slower rate to lower the risk of reaction. They might also give you medications before future Imfinzi (durvalumab) infusions to prevent the reaction from happening again.
Stem cell transplant complications
Risk factors: Receiving an allogeneic stem cell transplant prior to or after starting Imfinzi (durvalumab) treatment
If you’ve received a stem cell transplant or are considering getting a stem cell transplant, talk to your healthcare team prior to starting Imfinzi (durvalumab) to determine if it’s safe for you to take. Treatment with immunotherapy targeting PD-L1 before or after receiving a stem cell transplant from a stem cell donor (allogeneic stem cell transplant) led to serious or even fatal transplant complications. These complications included the transplanted immune system attacking the new host (graft-versus-host disease) and liver problems related to the stem cell transplant (veno-occlusive disease). Because of these risks, your oncologist will need to talk to you about monitoring or other safer treatment options.
Harm to the unborn baby
Imfinzi (durvalumab) hasn’t been studied in human pregnancy, but it’s likely to cause harm or death to the unborn baby based on results from animal studies. If you’re able to become pregnant, your oncologist will have you do a pregnancy test before starting the medication. Use birth control during treatment and for 3 months after stopping the medication.
Imfinzi (durvalumab) dosage forms
Typical dosing for Imfinzi (durvalumab)
Your oncology team will determine your Imfinzi (durvalumab) dose and how often you'll receive it depending on what type of cancer you have. In addition, they might also give you other medications, like Imjudo (tremelimumab) or chemotherapy as part of your treatment.
For adults weighing 66 lbs or more:
Non-small cell lung cancer (NSCLC) that can be removed by surgery: The typical dose is 1,500 mg infused through the veins every 3 to 4 weeks. The maximum treatment time is 1 year after surgery.
NSCLC that can't be removed by surgery: The typical dose is 10 mg/kg every 2 weeks or 1,500 mg infused through the veins every 4 weeks. The maximum treatment time is 1 year.
Metastatic NSCLC: The typical dose is 1,500 mg infused through the veins every 3 weeks for 4 cycles, then 1,500 mg every 4 weeks.
Small cell lung cancer (SCLC): The typical dose is 1,500 mg infused through the veins every 3 weeks for 4 cycles, then 1,500 mg every 4 weeks.
Biliary tract cancers: The typical dose is 1,500 mg infused through the veins every 3 weeks for up to 8 cycles, then 1,500 mg every 4 weeks.
Liver cancers: The typical dose is 1,500 mg infused through the veins every 4 weeks.
Endometrial cancer: The typical dose is 1,120 mg infused through the veins every 3 weeks for 6 cycles, then 1,500 mg every 4 weeks.
Your dose will be different if your body weight is less than 66 lbs.
Imfinzi (durvalumab) images
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References
Best studies we foundAmerican Cancer Society. (2022). Cooling Caps (Scalp Hypothermia) to Reduce Hair Loss.
American Cancer Society. (2020). Coping with Hair Loss.
American Cancer Society. (2019). Small cell lung cancer stages.
American Cancer Society. (2020). What are infusion or immune reactions?
AstraZeneca Pharmaceuticals LP. (2024). Imfinzi- durvalumab injection, solution [package insert]. DailyMed.
AstraZeneca plc. (n.d.). Getting Imfinzi.
AstraZeneca plc. (n.d.). How are Imfinzi + Imjudo given?
AstraZeneca plc. (n.d.). How is Imfinzi + Imjudo with chemotherapy given?
AstraZeneca plc. (n.d.). How is Imfinzi given?
AstraZeneca plc. (n.d.). Imfinzi is an infusion given every 3 weeks for 3 months, in combination with chemotherapy.
National Cancer Institute. (n.d.). Allogeneic stem cell transplant.
National Cancer Institute. (n.d.). Cancer Fatigue.
National Cancer Institute. (n.d.). Hepatic veno-occlusive disease.
National Cancer Institute. (n.d.). Immune checkpoint inhibitor.
National Cancer Institute. (n.d.). Overall survival.
National Cancer Institute. (n.d.). PD-L1.
National Cancer Institute. (n.d.). What Is Bile Duct Cancer (Cholangiocarcinoma)?
National Comprehensive Cancer Network. (2022). Understanding immunotherapy side effects.
National Marrow Donor Program. (n.d.). Graft-versus-host disease basics.
Spigel, D. R., et al. (2022). Five-Year Survival Outcomes From the PACIFIC Trial: Durvalumab After Chemoradiotherapy in Stage III Non–Small-Cell Lung Cancer. Journal of Clinical Oncology.
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