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.

This treatment affects the immune system. This may cause inflammation in different parts of the body which can cause serious side effects. They could happen during treatment, or some months after treatment has finished. In some people, these side effects could be life threatening.

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.

Contact your doctor or nurse immediately if you have signs of infection, including a temperature above 37.5C or below 36C.

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 health care 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 immune system Open a glossary item 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.

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.

Last reviewed: 
11 May 2020
Next review due: 
11 May 2023
  • Electronic Medicines Compendium 
    Accessed January 2020

  • British National Formulary

    Accessed January 2020

  • Immunisation against infectious disease: Chapter 6: General contraindications to vaccination

    Public Health England

    First published: March 2013 and regularly updated on the Gov.UK website

  • Durvalumab after Chemoradiotherapy in Stage III Non–Small-Cell Lung Cancer

    A J Scott and others, 2017

    New England Journal of Medicine. Volume 377

  • Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation (Information for the public)

    National Institute for Health and Care Excellence (NICE), 2019

  • Durvalumab (non-small cell lung cancer systemic anti cancer protocol)

    The Clatterbridge Cancer Centre NHS Foundation Trust, April 2019

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