Treatment Name: Durvalumab (Imfinzi®)
How does durvalumab work?
Durvalumab (Imfinzi®) is designed to enhance your immune system’s ability to target and specifically kill cancer cells for a lung cancer patient. Sometimes, cancer cells can 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 lung cancer and kill it.
Goals of therapy:
Durvalumab is given to patients with the goal of shrinking tumors and decreasing symptoms of lung cancer. Durvalumab is not commonly given with the goal of cure, but rather to prolong survival.
- Durvalumab intravenous (I.V.) infusion over 60 minutes on Day 1
Estimated total infusion time for this treatment:
- Up to two 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 treatment is usually given in an outpatient infusion center, allowing the person to go home afterwards.
Durvalumab is repeated every 14 days. This is known as one Cycle. Each cycle may be repeated up to a maximum of 26 times (12 months of therapy), until the treatment no longer works, or unacceptable side effects occur.
Duration of therapy depends upon response, tolerability, and number of cycles prescribed.
Click here for the common Durvalumab (Imfinzi®) starting dose.
In clinical studies, the most common side effects reported for durvalumab (Imfinzi®) are shown here:
- Cough, (35%)
- Lung inflammation, (34%)
- Fatigue, (24%)
- Shortness of breath, (22%)
- Diarrhea, (18%)
- Fever, (15%)
- Decreased appetite, (14%)
- Nausea, (14%)
- Pneumonia, (13%)
- Joint pain, (12%)
- Itching, (12%)
- Skin rash, (12%)
- Sinus infection, (12%)
- Constipation, (12%)
- Decreased thyroid function, (12%)
- Headache, (11%)
- Weakness, (11%)
- Back pain, (11%)
- Muscle pain, (8%)
- Low red blood cells [anemia]. (8%)
Note: side effects of lung cancer patients involving the lungs such as cough, lung inflammation, and shortness of breath may be due to other treatments such as radiation or the lung cancer itself.
On average, 15% of patients discontinue this treatment due to unacceptable side effects.
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 8 to 12 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 treatment as planned, delay the next dose until the side effect goes away, change the dose, or switch to an alternative therapy.
- Because durvalumab enhances your immune system response to cancer, it may cause unintended side effects which can affect healthy cells as well. Some organs that might 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, medications 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 lung cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov 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:
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.
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®)