Durvalumab

Durvalumab is a human monoclonal antibody that inhibits programmed death-ligand 1 (PD-L1). Marketed as Imfinzi by AstraZeneca, it is an immune checkpoint inhibitor used in the treatment of certain cancers.

Mechanism of action: Durvalumab binds PD-L1, blocking its interaction with PD-1 and CD80. This releases T cells from suppression and can enhance anti-tumor immune responses.

Clinical use: Durvalumab is approved for unresectable, stage III non-small cell lung cancer as consolidation therapy after chemoradiation, and for some patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy. Approvals vary by country and region.

Administration: It is given by intravenous infusion, commonly every two to four weeks, with the duration continuing until disease progression or unacceptable toxicity based on the approved regimen.

Safety: Common adverse events include immune-related effects such as pneumonitis, hepatitis, colitis, endocrinopathies (e.g., hypothyroidism, hyperthyroidism), and infusion-related reactions. Patients require monitoring of organ function and thyroid function, and treatment may be interrupted or discontinued for toxicity.

Pharmacology and development: Durvalumab is a human IgG1 monoclonal antibody designed to target PD-L1. Its development includes trials across various cancers, and while PD-L1 expression can correlate with response in some settings, responses occur across a range of biomarker statuses.