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Treatment Name: Durvalumab (Imfinzi®)

Durvalumab (Imfinzi®) is an Immunotherapy Regimen for Bladder Cancer

How does durvalumab work?
Durvalumab is designed to enhance your immune system’s ability to target and specifically kill cancer cells; this is also known as immunotherapy. Sometimes, cancer cells have the ability to escape discovery from specific cancer-fighting cells known as T-cells. One way cancer cells do this is by expressing a protein called programmed cell death ligand-1 (PD-L1), which blocks activation of T-cells. By attaching to and blocking PD-L1, durvalumab helps your body’s T-cells stay activated so they can recognize the cancer and kill it.

Goals of therapy:
Durvalumab is given to patients with the goal of shrinking tumors and decreasing symptoms of bladder cancer. Durvalumab is not commonly given with the goal of cure.


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  • Durvalumab intravenous (I.V.) infusion over 60 minutes on Day 1

Estimated total infusion time for this treatment:

  • Up to 2 hours for Day 1 of each cycle
  • Infusion times are based on clinical studies, but may vary depending on doctor preference or patient tolerability. Pre-medications and I.V. fluids, such as hydration, may add more time

Durvalumab is usually given in an outpatient infusion center, allowing the person to go home afterwards. It is repeated every 14 days. This is known as one Cycle.

Each cycle may be repeated until the treatment no longer works or until unacceptable side effects occur. Duration of therapy depends upon response, tolerability, and number of cycles prescribed.

Click here for the common durvalumab (Imfinzi®) starting doses.


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Side Effects

In clinical studies, the most commonly reported drug side effects of durvalumab (Imfinzi®) are shown here:

  • Fatigue (13%),
  • Diarrhea (10%),
  • Decreased appetite (8%),
  • Joint pain (7%),
  • Weakness (7%),
  • Nausea (7%),
  • Fever (7%),
  • Infusion reaction (3%),
  • Itching (3%),
  • Kidney injury (2%).

On average, 2% of patients discontinue treatment due to unacceptable drug side effects.

Side effect videos Side Effect Videos
Fatigue Fatigue DiarrheaDiarrheaPainPainNausea and VomitingNausea and Vomiting


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How often is monitoring needed?
Labs (blood tests) may be checked before treatment and in-between treatment as needed. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), thyroid function tests, plus any others your doctor may order.

How often is imaging needed?
Imaging may be checked before treatment then approximately every 6 to 8 weeks during treatment. Imaging may include: magnetic resonance imaging (MRI), computerized tomography (CT) scans, or positron emission tomography (PET) scans.

How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue durvalumab as planned, delay the next dose until the side effect goes away, or switch to an alternative therapy.


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ChemoExperts Tips

  • Because durvalumab enhances your immune system response to cancer, it may cause unintended side effects that are caused by the immune system and affect healthy cells as well. Some organs that can be affected include the thyroid, pituitary gland, adrenal glands, pancreas, gastrointestinal tract, liver, lungs, skin, kidneys, and others. A corticosteroid (e.g., prednisone, methylprednisolone) may be prescribed by your doctor to help improve symptoms if the immune system attacks healthy tissues during treatment. In some cases, medication such as infliximab (Remicade®), mycophenolate mofetil (CellCept®), or vedolizumab (Entyvio®) may need to be used along with corticosteroids if symptoms worsen or don’t improve
  • A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
  • Clinical trials may exist for bladder cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to to search for other centers offering study medications

Patient Assistance & Co-payment Coverage

Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for Durvalumab (Imfinzi®), we have provided links that may help.

Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for Durvalumab (Imfinzi®). Depending upon your income, they may be able to help cover the cost of:

  • Durvalumab

For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.

  • If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.

Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as Durvalumab (Imfinzi®) and are the best source to help you understand drug cost.

  • Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.

Emotional Wellness

What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.

Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.

Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.

Learn more about pursuing emotional wellness while receiving treatment with Durvalumab (Imfinzi®)

Individual Drug Label Information

Durvalumab (Imfinzi®)

  • Is an intravenous (I.V.) infusion
  • Is a clear to slightly yellow solution
  • Doses may need to be delayed or adjusted due to: lung, liver, colon/gastrointestinal tract (colitis), endocrinopathies (problems with thyroid, adrenal glands or pancreas), kidney, skin reactions, or other treatment-related problems
  • Inflammation of the lungs is rare, but serious if it occurs. Call your doctor immediately if you notice change in breathing, worsening cough, or chest pain as immediate treatment may be necessary. Treatment of this condition, known as pneumonitis, may be treated with corticosteroids such as prednisone
  • Liver inflammation may occur and is usually found through blood tests and may not cause any symptoms early in treatment. Durvalumab therapy may need to be put on hold if this occurs, or steroid treatment may be started to help the liver recover. It may be possible to restart treatment if the liver fully recovers. Signs of liver problems may include yellowing of eyes or skin, pain on right side of abdomen, or easy bruising or bleeding
  • Intestine (colon) inflammation is relatively common and often causes diarrhea, with or without abdominal pain. Durvalumab therapy may need to be put on hold if this occurs, or steroid treatment may be started to help the intestines recover. It may be possible to restart treatment if the intestines recover
  • Durvalumab may cause fetal harm in a pregnant woman. Females of childbearing potential should use effective contraception during treatment and for one month after finishing treatment. Breastfeeding infants while on this drug is not advised
General side effects from Durvalumab (Imfinzi®)
  • Cough
  • Lung inflammation 
  • Fatigue
  • Shortness of breath
  • Diarrhea
  • Fever
  • Decreased appetite
  • Nausea
  • Pneumonia
  • Joint pain
  • Itching
  • Skin rash
  • Sinus infection
  • Constipation
  • Decreased thyroid function
  • Headache
  • Weakness
  • Back pain
  • Muscle pain
  • Low red blood cells [anemia]
  • Click on the Durvalumab (Imfinzi®) DailyMed package insert link below for all reported side effects and possible drug interactions

Side Effect Videos
Nausea and VomitingNausea and VomitingDiarrheaDiarrheaFatigue Fatigue ConstipationConstipationPainPainAnemiaAnemia

See DailyMed package insert.

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Massard C, Gordon MS, Sharma S, et al. Safety and Efficacy of Durvalumab (MEDI4736), an Anti-Programmed Cell Death Ligand-1 Immune Checkpoint Inhibitor, in Patients With Advanced Urothelial Bladder Cancer. J Clin Oncol 2016;34(26):3119-25.

Created: January 28, 2019 Updated: January 28, 2019

What is Bladder Cancer?

A disease of the cells that line the inside of the bladder. Bladder cancer is a rare disease that is most commonly seen in older adults. It is known to cause blood in the urine in up to 90% of patients at diagnosis. Causes of bladder cancer include smoking, exposure to certain chemicals (arylamines), and chronic bladder infections.

Treatment includes surgery (full or partial removal of the bladder), chemotherapy, immunotherapy (giving certain vaccines into the bladder), or thermotherapy (heating the lining of the bladder combined with chemotherapy). The stage of bladder cancer can vary at diagnosis and throughout treatment. Bladder cancer is staged using the Tumor, Node, Metastasis (TNM) system, as well as Stage Grouping 0, I, II, III, or IV. Staging systems describe the extent of cancer throughout the body and help doctors determine which treatments to offer. The effectiveness of the treatment may depend upon the stage at diagnosis.

NOTE: Treatment Options listed below are not all-inclusive. Other treatments may be available. ChemoExperts provides drug information and does not recommend any one treatment over another. Only your Doctor can choose which therapy is appropriate for you.

What does Cure mean?

The word “cure” means there are no cancer cells left in the body and cancer will never come back. Depending on the cancer type and stage, this may be the true goal of therapy. However, it is very difficult to prove all cancer cells are gone. Even though images, like X-rays and MRI’s, and blood tests may not show any signs of cancer, there can be a small amount of cancer cells still left in the body. Because of this, the word “remission” is used more often. This means there are no signs or symptoms of cancer. Patients in remission are followed closely for any signs of cancer returning. Sometimes, more chemotherapy may be given while in remission to prevent the cancer from coming back.

Doctors usually do not consider a patient “cured” until the chance of cancer returning is extremely low. If cancer does return, it usually happens within 5 years of having a remission. Because of this, doctors do not consider a patient cured unless the cancer has not come back within 5 years of remission. The five-year cutoff does not apply to all cancers.

What is a CBC?

A Complete Blood Count (CBC) is a frequently ordered blood test that tells clinicians the status of your: 1) White blood cell count, 2) Hemoglobin, and 3) Platelet count at the time the test was taken.

Common uses:
1) White blood cell count (WBC): is used to determine infection risk, or response to chemotherapy. Certain chemotherapy agents may harm our good infection-fighting cells. Sometimes chemotherapy may need to be delayed to allow these cells to recover.

2) Hemoglobin: is used to determine if someone is anemic. Anytime the hemoglobin is below 12 g/dL, the person is said to be anemic. Red blood cell transfusions, and sometimes iron can be given to restore the hemoglobin level, but anemia treatment should always aim at treating the underlying cause or condition.

3) Platelet count: is used to determine if the risk of bleeding is increased or if a platelet transfusion is required to prevent bleeding. Certain medications that increase bleeding risk, such as: aspirin, certain chemotherapy agents, and blood thinners, may need to be stopped temporarily until the platelet count is within a safe range.

What is a CMP?

A Comprehensive Metabolic Panel (CMP) is a frequently ordered blood test that tells clinicians the status of your: 1) Electrolytes & Acid/Base status2) Kidney function, 3) Liver function, 4) Blood sugar, and 5) Calcium at the time the test was taken. It is commonly used to monitor liver and kidney function when beginning new medications such as chemotherapy. A total of 14 tests are run simultaneously and are shown below.

Electrolytes & Acid/Base status:
1) Sodium, 2) Potassium, 3) Carbon dioxide, 4) Chloride

Kidney Function:
5) BUN (blood urea nitrogen), 6) Serum creatinine (Scr)

Liver Function:
7) AST, 8) ALT, 9) Total bilirubin, 10) Alk Phos, 11) Albumin, 12) Total protein

Blood sugar:
13) Serum glucose

14) Serum calcium

Common Starting Doses

  • Durvalumab 10 mg/kg intravenous (I.V.) infusion over 60 minutes on Day 1 of every 14-day Cycle

Note: Individual doses may vary based upon your Doctor's recommendation, or drug availability.