Durvalumab (Imfinzi)
Durvalumab is a type of immunotherapy. It is also known by its brand name, Imfinzi. You might have it as a treatment for non small cell lung cancer (NSCLC).
You might also have durvalumab as part of a clinical trial for another type of cancer.
How durvalumab works
Durvalumab stimulates the body's immune system to fight cancer cells.
Durvalumab seeks out cancer cells by looking for the PD-L1 protein and attaching to it. The immune system then recognises the marked cells and kills them.
How you have durvalumab
You usually have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Central line
You might have treatment through a long plastic tube that goes into a large vein in your chest. The tube stays in place throughout the course of treatment. This is likely to be a PICC line.
When you have durvalumab
You usually have durvalumab every 2 weeks. It takes about an hour each time you have it. You have durvalumab for as long as it works and the side effects are not too bad. You usually have it for up to a year.
Tests
You have blood tests before and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Side effects
We haven't listed all the side effects. It is very unlikely that you will have all of these side effects, but you might have some of them at the same time.
How often and how severe the side effects are can vary from person to person.
When to contact your team
Your doctor or nurse will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:
- you have severe side effects
- your side effects aren’t getting any better
- your side effects are getting worse
Early treatment can help manage side effects better.
Common side effects
These side effects happen in more than 10 in 100 people (more than 10%). You might have one or more of them. They include:
Lung problems
You might develop a cough or breathing problems. This could be due to infection, such as pneumonia or inflammation of the lungs (pneumonitis). Let your doctor or nurse know straight away if you suddenly become breathless or develop a cough.
Infections of the sinus’ and throat (upper respiratory tract infections)
You might have an infection of your upper airways or throat. You might:
- be sneezing
- have a stuffy or runny nose
- have a sore throat
- have a croaky voice
High temperature
If you get a high temperature, let your healthcare team know straight away. Ask them if you can take paracetamol to help lower your temperature.
Changes to thyroid hormone levels
The level of your thyroid hormones may drop (hypothyroidism). You may feel tired or cold, gain weight, feel sad or depressed, or your voice may deepen. You will have regular blood tests to check your thyroid hormone levels.
Less commonly your level of thyroid hormones might go up.
Diarrhoea
Contact your advice line if you have diarrhoea, such as if you've had 4 or more loose watery poos (stools) in 24 hours. Or if you can't drink to replace the lost fluid. Or if it carries on for more than 3 days.
Your doctor may give you anti diarrhoea medicine to take home with you after treatment. Eat less fibre, avoid raw fruits, fruit juice, cereals and vegetables, and drink plenty to replace the fluid lost.
Tummy (abdominal) pain
Tell your treatment team if you have this. They can check the cause and give you medicine to help.
Skin rash
You might develop a skin rash on your face and body. It may appear like blisters on the skin. It may be itchy but not always.
If you notice a rash on your skin let your doctor know straight away.
Itchy skin
Your skin might feel itchy after having this drug. Let your doctor or nurse know if you have this.
Occasional side effects
These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:
- tooth or mouth infections including thrush (this looks like white patches in your mouth)
- the flu (influenza), symptoms include a sudden fever, feeling achy and very tired
- night sweats
- muscle pain
- hoarse voice
- changes to how your liver works - you have regular blood tests to check this
- changes to how your kidneys work - you have regular blood tests to check this
- swelling of your hands or lower legs
- finding it difficult or painful to wee
- inflammation of the bowel
- a reaction to durvulumab that happens on the day of the infusion or the day after – this might include a red, itchy rash (hives)
Rare side effects
These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:
- inflammation in the muscles or the blood vessels in the muscles
- severe muscle weakness
- high levels of glucose in your body (diabetes) – you might have regular blood sugar tests
- damage to the adrenal gland which can cause a drop in the level of certain hormones such as cortisol
- scarring of the lungs
- inflammation of the liver (hepatitis), kidneys or heart muscle
- inflammation or problems with hormone production in the brain
Coping with side effects
We have more information about side effects and tips on how to cope with them.
What else do I need to know?
Other medicines, foods and drinks
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Loss of fertility
It is not known whether this treatment affects fertility. Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 3 months afterwards. Talk to your doctor or nurse about contraception before starting treatment.
Breastfeeding
Don’t breastfeed during this treatment because the drug may come through into your breast milk.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Immunisations
Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and one of the shingles vaccines called Zostavax.
You can have:
- other vaccines, but they might not give you as much protection as usual
- the flu vaccine (as an injection)
- the coronavirus (COVID-19) vaccine - talk to your doctor or pharmacist about the best time to have it in relation to your cancer treatment
Members of your household who are aged 5 years or over are also able to have the COVID-19 vaccine. This is to help lower your risk of getting COVID-19 while having cancer treatment and until your 
recovers from treatment.
Contact with others who have had immunisations - You can be in contact with other people who have had live vaccines as injections. Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as the oral typhoid vaccine. Sometimes people who have had the live shingles vaccine can get a shingles type rash. If this happens they should keep the area covered.
If your immune system is severely weakened, you should avoid contact with children who have had the flu vaccine as a nasal spray as this is a live vaccine. This is for 2 weeks following their vaccination.
Babies have the live rotavirus vaccine. The virus is in the baby’s poo for about 2 weeks and could make you ill if your immunity is low. Get someone else to change their nappies during this time if you can. If this isn't possible, wash your hands well after changing their nappy.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.
