Pronunciation: im-FIN-zee
Generic name: durvalumab
Dosage form: injection (500 mg/10 mL, 120 mg/2.4 mL)
Drug class: Anti-PD-1 and PD-L1 monoclonal antibodies (immune checkpoint inhibitors)

Medically reviewed by Melisa Puckey, BPharm. Last updated on Jun 20, 2024.

What is Imfinzi?

Imfinzi is a type of immunotherapy used to treat types of lung cancer, biliary tract cancer (BTC), hepatocellular carcinoma, and endometrial cancer. Imfinzi works to reduce the growth and spread of cancer by helping the immune system find and recognize cancer cells and kill them.  

Imfinzi (durvalumab) is from a class of medications called immune checkpoint inhibitors that work by attaching to a protein on the cancer cells called PD-L1 which stimulates the immune system against the cancer cells.

Imfinzi is given as an infusion into a vein given every 2, 3 or 4 weeks, depending on your condition. Other medicines may be part of your treatment plan depending on the condition treated.

What is Imfinzi used for?

Imfinzi is FDA-approved to treat:

• non-small cell lung cancer (NSCLC) in patients whose tumors cannot be removed by surgery, and whose cancer has not progressed after treatment with chemotherapy and radiation (chemoradiation). It may also be used in combination with Imjudo (tremelimumab-actl) and platinum-based chemotherapy to treat NSCLC that has spread (metastatic NSCLC)
• small cell lung cancer (SCLC) in combination with the chemotherapy medicines etoposide and carboplatin or cisplatin when cancer has spread within your lungs or to other parts of the body
• biliary tract cancer (including cancer of the bile ducts and gallbladder cancer) in combination with the chemotherapy medicines gemcitabine and cisplatin when cancer has spread to nearby tissues or other parts of the body
• hepatocellular carcinoma (unresectable) in combination with Imjudo (tremelimumab-actl)
• endometrial cancer that has spread (advanced) or come back (recurrent) and tests show the tumor is mismatch repair deficient (dMMR), Imfinzi is used with carboplatin plus paclitaxel followed by single-agent Imfinzi.

Related/similar drugs

Opdivo, methotrexate, Keytruda, medroxyprogesterone, Avastin, Provera, cisplatin

Imfinzi side effects

Common Imfinzi side effects

Common Imfinzi side effects include cough, fatigue, pneumonitis/radiation pneumonitis, upper respiratory tract infections, dyspnea, and rash, when used as a single agent for Stage III NSCLC.

Common Imfinzi side effects when used with other cancer treatments may include nausea, constipation, decreased appetite, feeling weak or tired, bone or muscle pain, cough, feeling short of breath, cold symptoms such as stuffy nose, sneezing, sore throat, abdominal pain, fever, itchy skin, rash, painful urination, hair loss, vomiting, nerve inflammation (causing symptoms such as numbness, weakness, tingling, or burning), changes blood tests including decreased magnesium, increased ALT, and increased AST. Side effects profiles are dependent on the specific combination of therapies. 

Immune-mediated hypothyroidism was reported in 14% of people receiving Imfinzi in combination with carboplatin and paclitaxel. Events resolved in some patients, but all required endocrine therapy.

Serious Imfinzi side effects

Get emergency medical help if you have signs of an allergic reaction to this medicine: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Some side effects may occur during the injection. Tell your caregiver right away if you feel light-headed or itchy, or if you have a fever, chills, neck or back pain, trouble breathing, or flushing (warmth, redness, or tingly feeling).

This medicine causes your immune system to attack tumor cells, but it could also attack healthy organs and tissues in your body. This could lead to serious or life-threatening side effects on your lungs, liver, pancreas, kidneys, intestines, thyroid, or adrenal glands.

Call your doctor at once if you have:

• chest pain, new or worsening cough, feeling short of breath;
• severe stomach pain, diarrhea, bloody or tarry stools;
• new or worsening skin rash, itching, or blistering;
• fever, flu-like symptoms;
• pain or burning when you urinate;
• problems in other organs - mood or behavior changes, neck stiffness, confusion, eye pain or redness, vision problems;
• liver problems - loss of appetite, upper stomach pain, drowsiness, easy bruising or bleeding, dark urine, jaundice (yellowing of the skin or eyes);
• kidney problems - little or no urination, red or pink urine, swelling in your feet or ankles;
• transplant rejection - rash with blisters and peeling, watery diarrhea, stomach pain, vomiting, loss of appetite, fever, bruising or bleeding, jaundice, pain or swelling near your transplanted organ; or
• signs of a hormonal disorder - unusual headaches, feeling light-headed or very tired, hoarse or deepened voice, increased hunger or thirst, increased urination, constipation, vomiting, hair loss, feeling cold, weight gain, or weight loss.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Warnings

Imfinzi works by causing your immune system to attack tumor cells but it may also cause your immune system to attack healthy organs and tissues in your body. This could lead to serious or life-threatening side effects on your lungs, liver, pancreas, kidneys, intestines, thyroid, pituitary, or adrenal glands.

Call your doctor at once if you have new or unusual symptoms, such as: tiredness, mood changes, headaches, vision problems, muscle weakness, stomach problems, weight changes, skin rash, hair loss, bleeding or bruising, yellowing of your skin or eyes, increased or decreased urination, dark urine, bloody or tarry stools, worsening cough, chest pain, or trouble breathing.

Infusion-Related Reactions. Your infusion may be slowed, interrupted or permanently discontinued if you have an infusion-related reaction, depending on the severity of the reaction.

Complications of Allogeneic Hematopoietic Stem Cell Transplantation (HSCT). Fatal and other serious complications can occur in patients who receive allogeneic HSCT before or after being treated with a PD-1/PD-L1 blocking antibody.

Embryo-Fetal Toxicity: This medicine can cause fetal harm. Females of reproductive potential should be advised of the potential risk to a fetus and should use effective contraception. 

Before taking this medicine

You should not use this infusion if you are allergic to the active ingredient, durvalumab, or any of the inactive ingredients.

To make sure this medicine is safe for you, tell your doctor if you have an active infection or if you have ever had:

• an organ transplant or a stem cell transplant (recent or planned);
• lung disease or breathing problems;
• liver disease;
• radiation treatment of your chest area; or
• an autoimmune disorder such as lupus, ulcerative colitis, or Crohn's disease.

Pregnancy 

Imfinzi may harm an unborn baby. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 3 months after your last dose. Tell your doctor if you become pregnant.

Breastfeeding

Do not breastfeed while using medicine, and for at least 3 months after your last dose.

How is Imfinzi given?

Imfinzi is given as an infusion into a vein, usually once every 2, 3 or 4 weeks. A healthcare provider will give you this injection.

This medicine must be given slowly, and the infusion can take about 1 hour to complete.

Dosing information

Usual Adult Dose for Non-Small Cell Lung Cancer (NSCLC):

Less than 30kg:
10 mg/kg IV every 2 weeks until disease progression, unacceptable toxicity, or a maximum of 12 months

Greater than 30 kg:
10 mg/kg IV every 2 weeks OR 1500 mg every 4 weeks until disease progression, unacceptable toxicity, or a maximum of 12 months

Use: For patients with unresectable Stage III non-small cell lung cancer (NSCLC) whose disease has not progressed following concurrent platinum-based chemotherapy and radiation therapy

Usual Adult Dose for Metastatic NSCLC:

30 kg or less:
20 mg/kg every 3 weeks in combination with tremelimumab-actl 1 mg/kg and platinum-based chemotherapy, and then administer Imfinzi 20 mg/kg every 4 weeks as a single agent with histology-based pemetrexed therapy every 4 weeks, and a fifth dose of tremelimumab-actl 1 mg/kg in combination with Imfinzi dose 6 at week 16.

Greater than or equal to 30 kg: 1,500 mg every 3 weeks in combination with tremelimumab-actl 75 mg and platinum-based chemotherapy for 4 cycles, and then administer Imfinzi 1,500 mg every 4 weeks as a single agent with histology-based pemetrexed maintenance therapy every 4 weeks, and a fifth dose of tremelimumab-actl 75 mg in combination with Imfinzi dose 6 at week 16.

Use: the treatment of adult patients with metastatic NSCLC with no sensitizing epidermal growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) genomic tumor aberrations in combination with tremelimumab-actl and platinum-based chemotherapy.

Usual Adult Dose for Small Cell Lung Cancer:

30 kg or less:
20 mg/kg IV in combination with chemotherapy every 3 weeks (21 days) for 4 cycles, followed by 10 mg/kg every 4 weeks as a single agent until disease progression, unacceptable toxicity
NOTE: When this drug is given in combination with chemotherapy, administer this drug prior to chemotherapy on the same day; refer to the Prescribing Information for etoposide and carboplatin or cisplatin for dosing information.

Greater than 30 kg:
1500 mg IV in combination with chemotherapy every 3 weeks (21 days) for 4 cycles, followed by 1500 mg every 4 weeks as a single agent until disease progression or unacceptable toxicity
NOTE: When this drug is given in combination with chemotherapy, administer this drug prior to chemotherapy on the same day; refer to the Prescribing Information for etoposide and carboplatin or cisplatin for dosing information.

Use: First-line treatment of adult patients with extensive-stage small cell lung cancer (ES-SCLC) in combination with etoposide and either carboplatin or cisplatin.

Usual Adult Dose for Biliary Tract Cancer:

30 kg or less:
20 mg/kg IV in combination with chemotherapy every 3 weeks (21 days) for up to 8 cycles, followed by 20 mg/kg every 4 weeks as a single agent until disease progression or until unacceptable toxicity
NOTE: When this drug is given in combination with chemotherapy, administer this drug prior to chemotherapy on the same day; refer to the Prescribing Information for gemcitabine and cisplatin for dosing information.

Greater than 30 kg:
1500 mg IV in combination with chemotherapy every 3 weeks (21 days) for up to 8 cycles, followed by 1500 mg every 4 weeks as a single agent until disease progression or until unacceptable toxicity
NOTE: When this drug is given in combination with chemotherapy, administer this drug prior to chemotherapy on the same day; refer to the Prescribing Information for gemcitabine and cisplatin for dosing information.

Use: Locally advanced or metastatic biliary tract cancer (BTC) in combination with gemcitabine and cisplatin.

Usual Adult Dose for Unresectable Hepatocellular Carcinoma:

Less than 30 kg: 
20 mg/kg in combination with tremelimumab-actl 4 mg/kg as a single dose at Cycle 1/Day 1, followed by Imfinzi as a single agent every 4 weeks.

Greater than or equal to 30 kg: 
1,500 mg in combination with tremelimumab-actl 300 mg as a single dose at Cycle 1/Day 1, followed by Imfinzi as a single agent every 4 weeks.

Use: The treatment of adult patients with unresectable hepatocellular carcinoma in combination with tremelimumab-actl.

Usual Adult Dose for dMMR endometrial cancer

30 kg or less:
15 mg/kg in combination with carboplatin and paclitaxel* every 3 weeks (21 days) for 6 cycles, followed by Imfinzi 20 mg/kg every 4 weeks as a single agent Until disease progression or unacceptable toxicity.

Greater than 30 kg: 1,120 mg in combination with carboplatin and paclitaxel* every 3 weeks (21 days) for 6 cycles, followed by Imfinzi 1,500 mg every 4 weeks as a single agent.

Use: to treat endometrial cancer that has spread (advanced) or come back (recurrent) and tests show the tumor is mismatch repair deficient (dMMR), Imfinzi is used with carboplatin plus paclitaxel followed by single-agent Imfinzi.

Imfinzi is available as 

• 500 mg/10 mL (50 mg/mL) solution in a single-dose vial. 
• 120 mg/2.4 mL (50 mg/mL) solution in a single-dose vial.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your Imfinzi injection.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid while receiving Imfinzi?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

What other drugs will affect Imfinzi?

Other drugs may interact with durvalumab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Imfinzi Package Insert 

Review the Imfinzi Package Insert for more detailed information about this medicine. Discuss any medical questions you have with your doctor or other health care provider. This is not all the information you need to know about this medicine for safe and effective use, and it does not take the place of talking to your doctor about your treatment.

Ingredients

Active ingredient: durvalumab 

Inactive ingredients: L-histidine, L-histidine hydrochloride monohydrate, α,α-trehalose dihydrate, polysorbate 80, Water for Injection, USP.

Company

Manufactured for: AstraZeneca Pharmaceuticals LP, Wilmington, DE 19850 

Manufactured by: AstraZeneca UK Limited, 1 Francis Crick Ave. Cambridge, England CB2 0AA

Frequently asked questions

• What type of drug is Imfinzi?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer