What is Durvalumab: Uses, Dosage, Side Effects and More

Durvalumab is a type of cancer immunotherapy medication that helps your immune system fight certain types of cancer more effectively. It's given through an IV (intravenous) infusion, which means it flows directly into your bloodstream through a vein in your arm or chest.

This medication belongs to a class of drugs called checkpoint inhibitors, which work by removing the "brakes" that cancer cells put on your immune system. Think of it as helping your body's natural defenses recognize and attack cancer cells that were previously hiding from detection.

What is Durvalumab Used For?

Durvalumab is primarily used to treat specific types of lung cancer and bladder cancer. Your doctor prescribes this medication when other treatments haven't worked or when cancer has spread to other parts of your body.

The main conditions durvalumab treats include non-small cell lung cancer (NSCLC) that hasn't spread widely and certain types of advanced bladder cancer. It's often used after you've completed radiation therapy or when cancer has returned despite other treatments.

For lung cancer, durvalumab is typically given when the cancer is in stage III, meaning it's locally advanced but hasn't spread to distant parts of your body. In bladder cancer cases, it's usually reserved for advanced stages when the cancer has spread beyond the bladder itself.

How Does Durvalumab Work?

Durvalumab works by blocking a protein called PD-L1 that cancer cells use to hide from your immune system. When this protein is blocked, your immune cells can better recognize and attack the cancer.

Your immune system has built-in checkpoints that prevent it from attacking healthy cells. Cancer cells cleverly use these same checkpoints to protect themselves. Durvalumab removes this protection, allowing your immune system to do its job more effectively.

This medication is considered a targeted therapy rather than traditional chemotherapy. It's generally gentler on your body than conventional cancer treatments, though it can still cause side effects as your immune system becomes more active.

How Should I Take Durvalumab?

Durvalumab is given as an IV infusion in a hospital or cancer treatment center. You cannot take this medication at home or by mouth - it must be administered by trained healthcare professionals.

The infusion typically takes about 60 minutes to complete. You'll sit comfortably in a chair while the medication flows through an IV line into your bloodstream. Most people receive treatments every 2 to 4 weeks, depending on their specific condition.

Before each infusion, your healthcare team will check your vital signs and may give you medications to prevent allergic reactions. You don't need to fast before treatment, and you can eat normally on treatment days. Staying well-hydrated by drinking plenty of water is helpful.

How Long Should I Take Durvalumab For?

The length of durvalumab treatment varies significantly based on your specific cancer type and how well you respond to the medication. Some people receive treatment for several months, while others may continue for over a year.

For lung cancer, treatment typically continues for up to 12 months if you're tolerating it well and your cancer isn't progressing. For bladder cancer, treatment may continue indefinitely as long as it's helping control your cancer and not causing severe side effects.

Your doctor will regularly monitor your progress through scans and blood tests. They'll adjust your treatment plan based on how your cancer responds and how your body handles the medication. The goal is to continue treatment as long as it's benefiting you without causing unacceptable side effects.

What Are the Side Effects of Durvalumab?

Durvalumab can cause side effects because it activates your immune system, which sometimes attacks healthy tissues along with cancer cells. Most side effects are manageable, but some can be serious and require immediate medical attention.

Here are the most common side effects you might experience during treatment:

• Fatigue and feeling more tired than usual
• Cough or shortness of breath
• Skin rash or itching
• Diarrhea or changes in bowel movements
• Decreased appetite
• Muscle or joint pain
• Nausea

These common side effects typically develop gradually and can often be managed with supportive care and medications. Your healthcare team will work with you to minimize any discomfort.

While less common, durvalumab can cause more serious side effects that require immediate medical attention. These occur when your activated immune system attacks healthy organs in your body.

Serious side effects that need urgent care include:

• Severe lung inflammation (pneumonitis) causing persistent cough or breathing difficulties
• Liver problems with symptoms like yellowing skin, dark urine, or severe abdominal pain
• Severe diarrhea or colitis with blood in stool
• Thyroid problems causing extreme fatigue, weight changes, or heart palpitations
• Kidney problems with decreased urination or swelling
• Severe skin reactions with widespread rash or blistering
• Adrenal gland problems causing severe fatigue, dizziness, or fainting

Your medical team monitors you closely for these conditions through regular blood tests and physical exams. Most serious side effects are reversible with prompt treatment, often involving medications that calm your immune system.

Who Should Not Take Durvalumab?

Durvalumab isn't suitable for everyone, and your doctor will carefully evaluate whether it's safe for you before starting treatment. Certain medical conditions and circumstances make this medication potentially dangerous.

You should not receive durvalumab if you have a known severe allergic reaction to this medication or its components. Your doctor will also be very cautious if you have active autoimmune diseases where your immune system already attacks healthy tissues.

Conditions that require special consideration include:

• Active autoimmune diseases like rheumatoid arthritis, lupus, or inflammatory bowel disease
• History of severe immune-related side effects from other immunotherapy drugs
• Active infections that your immune system is fighting
• Organ transplant recipients taking immunosuppressive medications
• Pregnancy or breastfeeding
• Severe liver or kidney disease

Your doctor will weigh the potential benefits against the risks in your specific situation. Sometimes durvalumab can still be used with careful monitoring and additional precautions, even if you have some of these conditions.

Durvalumab Brand Names

Durvalumab is sold under the brand name Imfinzi. This is the only available brand name for this medication, as it's still under patent protection by the original manufacturer.

When you receive your treatment, you'll see "Imfinzi" on your medication labels and treatment records. Generic versions of durvalumab are not yet available, so all patients receive the same branded medication regardless of their insurance or treatment center.

Durvalumab Alternatives

Several other checkpoint inhibitor medications work similarly to durvalumab for treating cancer. Your doctor might consider these alternatives if durvalumab isn't suitable for you or if your cancer doesn't respond well to it.

Common alternatives include pembrolizumab (Keytruda), nivolumab (Opdivo), and atezolizumab (Tecentriq). These medications all work by blocking different checkpoint proteins, allowing your immune system to attack cancer more effectively.

The choice between these medications depends on your specific cancer type, previous treatments, and individual health factors. Your oncologist will recommend the best option based on current research and your unique medical situation.

Traditional alternatives like chemotherapy, radiation therapy, or targeted therapy drugs may also be considered depending on your cancer's characteristics and stage.

Is Durvalumab Better Than Pembrolizumab?

Durvalumab and pembrolizumab are both effective checkpoint inhibitors, but they work best for different types of cancer and situations. Neither medication is universally "better" - the choice depends on your specific cancer type and treatment history.

Durvalumab is specifically approved for certain lung and bladder cancers, while pembrolizumab treats a broader range of cancers including lung, bladder, skin, and many others. For lung cancer, durvalumab is often used after radiation therapy, while pembrolizumab might be used as a first-line treatment.

The side effect profiles are quite similar between these medications, though individual people may tolerate one better than the other. Your oncologist will choose based on which medication has the strongest evidence for your specific cancer type and stage.