Durvalumab (Imfinzi)

Durvalumab, sold as Imfinzi, is an immunotherapy drug that blocks PD-L1, a protein tumors use to switch off the immune system. It is approved for several cancers, including some lung cancers, and has been tested with chemotherapy as a first treatment for pleural mesothelioma, but it is not an approved mesothelioma treatment in the United States.

Origin

Durvalumab is a monoclonal antibody developed by MedImmune, part of AstraZeneca, and first approved in the United States in 2017 for bladder cancer. In mesothelioma, the Australian DREAM trial and the U.S. PrE0505 trial tested it with cisplatin and pemetrexed, and a larger trial, DREAM3R, followed.

Significance in Asbestos Context

In the DREAM and PrE0505 phase 2 trials, adding durvalumab to standard chemotherapy as a first treatment produced encouraging response and survival results, which led to the larger DREAM3R comparison against chemotherapy alone. Phase 2 results are not proof of benefit, and patients should rely on their oncologist for whether durvalumab is a reasonable option or whether a trial is open to them. In lung cancer, durvalumab is widely used after chemoradiation for stage III non-small cell lung cancer, so asbestos-exposed workers with lung cancer may receive it. Like other checkpoint inhibitors, it can cause immune-related side effects, such as pneumonitis, colitis and thyroid problems, which can appear months into treatment. Treatment records with drug names, dates and side effects help document the course of the illness and its medical costs in a claim.

Example Sentence

She enrolled in a trial of durvalumab with cisplatin and pemetrexed, and her infusion records list each dose and the thyroid side effect that followed.

Related Terms

Immunotherapy, PD-L1, Checkpoint Inhibitors, Platinum-Pemetrexed, Clinical Trial, Immune-Related Adverse Events, Non-Small Cell Lung Cancer, Monoclonal Antibody

Notes

• Ask whether a drug is approved for your cancer or is being given in a trial or off-label; insurance coverage can differ.
• Report a new cough, shortness of breath, diarrhea or unusual tiredness promptly, during and after treatment.
• Keep infusion records and any trial consent forms.