Select a medication above to begin.
Imfinzi
durvalumab
Adult Dosing .
Dosage forms: INJ
Special Note
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing including toxicity-related dose adjustments
non-small cell lung CA
- [resectable disease, neoadjuvant tx, <30 kg]
- Dose: 20 mg/kg/dose IV q3wk for up to 4 cycles; Info: for patients w/ tumor >4cm or node-positive disease w/ no EGFR or ALK genomic tumor aberrations; part of multi-drug chemo regimen
- [resectable disease, neoadjuvant tx, >30 kg]
- Dose: 1500 mg IV q3wk for up to 4 cycles; Info: for patients w/ tumor >4cm or node-positive disease w/ no EGFR or ALK genomic tumor aberrations; part of multi-drug chemo regimen
- [resectable disease, adjuvant tx following neoadjuvant tx, <30 kg]
- Dose: 20 mg/kg/dose IV q4wk for up to 12 cycles; Max: 12 cycles; Info: for patients w/ tumor >4cm or node-positive disease w/ no EGFR or ALK genomic tumor aberrations
- [resectable disease, adjuvant tx following neoadjuvant tx, >30 kg]
- Dose: 1500 mg IV q4wk for up to 12 cycles; Max: 12 cycles; Info: for patients w/ tumor >4cm or node-positive disease w/ no EGFR or ALK genomic tumor aberrations
- [stage III unresectable disease, <30 kg]
- Dose: 10 mg/kg/dose IV q2wk x12mo; Max: 12mo; Info: for non-progressive disease after concurrent platinum-based chemo and XRT
- [stage III unresectable disease, >30 kg]
- Dose: 10 mg/kg/dose IV q2wk x12mo; Max: 12mo; Alt: 1500 mg IV q4wk x12mo, max 12mo; Info: for non-progressive disease after concurrent platinum-based chemo and XRT
- [metastatic disease, <30 kg]
- Dose: 20 mg/kg/dose IV q3wk x4 cycles on wk 0, 3, 6, 9, then 20 mg/kg/dose IV q4wk starting cycle 5 on wk 12; Info: for patients w/ no EGFR or ALK genomic tumor aberrations; part of multi-drug chemo regimen
- [metastatic disease, >30 kg]
- Dose: 1500 mg IV q3wk x4 cycles on wk 0, 3, 6, 9, then 1500 mg IV q4wk starting cycle 5 on wk 12; Info: for patients w/ no EGFR or ALK genomic tumor aberrations; part of multi-drug chemo regimen
small cell lung CA
- [limited stage disease, <30 kg]
- Dose: 20 mg/kg/dose IV q4wk x24mo; Max: 24mo; Info: for non-progressive disease after concurrent platinum-based chemo and XRT
- [limited stage disease, >30 kg]
- Dose: 1500 mg IV q4wk x24mo; Max: 24mo; Info: for non-progressive disease after concurrent platinum-based chemo and XRT
- [extensive-stage disease, first-line tx, <30 kg]
- Dose: 20 mg/kg/dose IV q3wk x4 cycles as part of multi-drug chemo regimen, then 10 mg/kg/dose IV q2wk as monotherapy
- [extensive-stage disease, first-line tx, >30 kg]
- Dose: 1500 mg IV q3wk x4 cycles as part of multi-drug chemo regimen, then 1500 mg IV q4wk as monotherapy
biliary tract CA, locally advanced or metastatic
- [<30 kg]
- Dose: 20 mg/kg/dose IV q3wk for up to 8 cycles as part of multi-drug chemo regimen, then 20 mg/kg/dose IV q4wk as monotherapy
- [>30 kg]
- Dose: 1500 mg IV q3wk for up to 8 cycles as part of multi-drug chemo regimen, then 1500 mg IV q4wk as monotherapy
hepatocellular CA, unresectable
- [<30 kg]
- Dose: 20 mg/kg/dose IV x1 on day 1 of cycle 1 w/ tremelimumab, then 20 mg/kg/dose IV q4wk as monotherapy
- [>30 kg]
- Dose: 1500 mg IV x1 on day 1 of cycle 1 w/ tremelimumab, then 1500 mg IV q4wk as monotherapy
mismatch repair deficient endometrial CA, advanced or recurrent
- [<30 kg]
- Dose: 15 mg/kg/dose IV q3wk x6 cycles as part of multi-drug chemo regimen, then 20 mg/kg/dose IV q4wk as monotherapy
- [>30 kg]
- Dose: 1120 mg IV q3wk x6 cycles as part of multi-drug chemo regimen, then 1500 mg IV q4wk as monotherapy
muscle invasive bladder CA
- [neoadjuvant tx, <30 kg]
- Dose: 20 mg/kg/dose IV q3wk x4 cycles; Info: part of multi-drug chemo regimen
- [neoadjuvant tx, >30 kg]
- Dose: 1500 mg IV q3wk x4 cycles; Info: part of multi-drug chemo regimen
- [adjuvant tx following neoadjuvant tx, <30 kg]
- Dose: 20 mg/kg/dose IV q4wk for up to 8 cycles; Max: 8 cycles
- [adjuvant tx following neoadjuvant tx, >30 kg]
- Dose: 1500 mg IV q4wk for up to 8 cycles; Max: 8 cycles
gastric CA, resectable
- [neoadjuvant tx, <30 kg]
- Dose: 20 mg/kg/dose IV q4wk for up to 2 cycles; Info: for patients w/ gastric or gastroesophageal junction adenocarcinoma; part of multi-drug chemo regimen
- [neoadjuvant tx, >30 kg]
- Dose: 1500 mg IV q4wk for up to 2 cycles; Info: for patients w/ gastric or gastroesophageal junction adenocarcinoma; part of multi-drug chemo regimen
- [adjuvant tx following neoadjuvant tx, <30 kg]
- Dose: 20 mg/kg/dose IV q4wk for up to 2 cycles as part of multi-drug chemo regimen, then 20 mg/kg/dose IV q4wk for up to 10 cycles as monotherapy; Max: 12 cycles; Info: for patients w/ gastric or gastroesophageal junction adenocarcinoma
- [adjuvant tx following neoadjuvant tx, >30 kg]
- Dose: 1500 mg IV q4wk for up to 2 cycles as part of multi-drug chemo regimen, then 1500 mg IV q4wk for up to 10 cycles as monotherapy; Max: 12 cycles; Info: for patients w/ gastric or gastroesophageal junction adenocarcinoma
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [see below]
- bilirubin 1.1-3x ULN: no adjustment; bilirubin >3x ULN: not defined
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- avoid: breastfeeding during tx and x3mo after D/C
- caution: patients of childbearing potential
- caution: thoracic XRT history
- caution: transplant history
- caution: transplant candidates
Drug Interactions .
Overview
durvalumab
PD-L1 blocking antibody
- immunomodulatory effects
Contraindicated
- adenovirus vaccine, live
- chikungunya vaccine, live
- cholera vaccine, live
- dengue vaccine, live
- influenza nasal vaccine, live
- measles/mumps/rubella vaccine, live
- rotavirus vaccine, live
- smallpox vaccine, live
- typhoid vaccine, live
- varicella vaccine, live
- yellow fever vaccine, live
Avoid/Use Alternative
- rabies vaccine
Monitor/Modify Tx
- anthrax vaccine
- chikungunya vaccine
- COVID-19 vaccine
- diphtheria/tetanus vaccine
- diphtheria/tetanus/pertussis vaccine
- ebola vaccine, live
- Haemophilus b vaccine
- hepatitis A vaccine
- hepatitis B vaccine
- human papillomavirus vaccine
- influenza H5N1 vaccine
- influenza vaccine
- Japanese encephalitis vaccine
- meningococcal vaccine
- pneumococcal vaccine
- poliovirus vaccine
- respiratory syncytial virus vaccine
- smallpox/mpox vaccine, live
- tick-borne encephalitis vaccine
- typhoid vaccine
Adverse Reactions .
Serious Reactions
- immune-mediated reaction
- pneumonitis
- interstitial lung disease
- hepatitis
- colitis
- diarrhea, severe
- endocrinopathy
- hypothyroidism
- hyperthyroidism
- thyroiditis
- adrenal insufficiency
- diabetes mellitus, type 1
- hypophysitis
- hypopituitarism
- pancreatitis
- nephritis
- aplastic anemia
- hemolytic anemia
- pancytopenia
- thrombosis
- immune thrombocytopenia
- histiocytic necrotizing lymphadenitis
- hemophagocytic lymphohistiocytosis
- myocarditis
- pericarditis
- vasculitis
- meningitis
- encephalitis
- demyelination
- myasthenia gravis
- Guillain-Barre syndrome
- nerve paresis
- uveitis
- Vogt-Koyanagi-Harada-like syndrome
- myositis
- rhabdomyolysis
- polymyalgia rheumatica
- autoimmune neuropathy
- hypoparathyroidism
- infection, severe
- infusion reaction, severe
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- drug reaction w/ eosinophilia and systemic symptoms
Common Reactions
- pneumonitis
- cough
- fatigue
- rash
- dyspnea
- URI
- pneumonia
- diarrhea
- hypothyroidism
- pruritus
- fever
- abdominal pain
- appetite decr.
- dizziness
- nausea
- hyperthyroidism
- constipation
- dysphonia
- dysuria
- night sweats
- peripheral edema
- infection
- hepatitis
- pancreatitis
- infusion reaction
- colitis
- hyperglycemia
- hypocalcemia
- ALT or AST incr.
- hyponatremia
- hyperkalemia
- GGT incr.
- lymphopenia
Safety/Monitoring .
Monitoring Parameters
pregnancy test at baseline; Cr, LFTs, TFTs at baseline, then periodically; glucose; signs/symptoms of infusion reaction
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; risk of embryo-fetal toxicity, including spontaneous abortion and stillbirth, based on animal data at 6-20x recommended human dose and drug's mechanism of action
Individuals of Reproductive Potential
obtain pregnancy test before tx start; avoid pregnancy by using effective contraception during tx and x3mo after D/C in patients of childbearing potential
Lactation
Clinical Summary
avoid breastfeeding during tx and x3mo after D/C; no human data available to assess risk of infant harm or effects on milk production
Pharmacology .
Metabolism: for durvalumab: other; CYP450: unknown
Excretion: for durvalumab: other; Half-life: 21 days
Subclass: Immunotherapy, Immune Checkpoint Inhibitors ; Immunotherapy, PD-1/PD-L1 Inhibitors
Mechanism of Action
for durvalumab: binds to PD-L1 on tumor cells and tumor-infiltrating immune cells, blocking PD-1/PD-L1 pathway-mediated inhibition of anti-tumor immune response, resulting in decreased tumor growth (monoclonal antibody)
Formulary .
No Formulary Selected
Join Now to View Patient Handouts!
Create a FREE epocrates Online account to access patient medication instructions. Your patients and caregivers will appreciate you printing these friendly handouts, available in English and Spanish. Each handout addresses common concerns such as how to take the medication, and possible side effects.
Current Members: Sign In.
Pill Pictures
Join Now to View Pill Pictures!
Create a FREE epocrates Online account to access full-color images of medications within the drug monograph.
Current Members: Sign In.