Imfinzi (Durvalumab) is a monoclonal antibody used in the treatment of various cancers. It targets the PD-L1 (Programmed Death-Ligand 1) protein, blocking its interaction with PD-1 and CD80, thus enhancing the immune system's ability to detect and destroy cancer cells.

Uses

Non-Small Cell Lung Cancer (NSCLC): For unresectable Stage III NSCLC after chemoradiotherapy.

Small Cell Lung Cancer (SCLC): In combination with chemotherapy for extensive-stage SCLC.

Biliary Tract Cancer (BTC): In combination with gemcitabine and cisplatin.

Durvalumab inhibits PD-L1 binding to PD-1 and CD80, restoring T-cell activation and proliferation. This boosts the immune response against cancer cells.

Dosages

NSCLC: 10 mg/kg intravenously every 2 weeks for up to 12 months.

SCLC: 1500 mg intravenously every 3 weeks during chemotherapy, followed by every 4 weeks as maintenance.

BTC: 1500 mg intravenously every 3 weeks in combination with chemotherapy.

Administration

• Administer via intravenous infusion over 60 minutes.
• Monitor for infusion-related reactions.

Side Effects

Common Side Effects:

1. Fatigue
2. Nausea
3. Decreased appetite
4. Cough
5. Constipation

Serious Side Effects:

1. Immune-Mediated Adverse Events: Pneumonitis, colitis, hepatitis, endocrinopathies, nephritis.
2. Infusion Reactions: Fever, chills, rash, or difficulty breathing.
3. Infections: Higher susceptibility due to immune modulation.

Contraindications

• Severe hypersensitivity to Durvalumab or any excipient.

Drug Interactions

1. Immunosuppressive Drugs: May reduce efficacy (e.g., corticosteroids).
2. Live Vaccines: Avoid due to risk of severe infections.

Onset and Duration of Action

• Onset: Variable; immune response may take weeks.
• Duration: Effects last as long as the immune system remains activated, typically weeks to months after discontinuation.

Monitoring Parameters

1. Before Treatment: Baseline liver, kidney, and thyroid function tests.
2. During Treatment: Regular monitoring for immune-mediated side effects and organ function.

Precautions

1. Monitor for immune-mediated adverse reactions and manage promptly with corticosteroids if needed.
2. Avoid in pregnancy due to potential harm to the fetus.
3. Use effective contraception during and after treatment (up to 3 months).
4. Assess cardiac function in patients with pre-existing conditions.

Storage

• Store vials at 2°C to 8°C.
• Protect from light. Do not freeze.