What Is Durvalumab?
Durvalumab is an immunotherapy medication used to treat cancer, specifically cancers of the lung and bladder. Its brand name form, AstraZeneca’s Imfinzi®, was approved by the U.S. Food and Drug Administration (FDA) on May 1, 2017, for patients with previously-treated, advanced-stage bladder cancer. The following year it was approved to treat stage 3 non-small cell lung cancer with tumors that were considered unresectable (or, unremovable by surgery). More recently, it has been used in clinical trials as a secondary treatment for mesothelioma, following a combination of chemotherapy and radiation therapy.
Durvalumab is administered by injection intravenously (IV) via an infusion over 60 minutes. Typically, patients receive durvalumab injections once every two weeks for as long as the cancer care team has prescribed. As an immunotherapy drug, it attaches to the PD-L1 protein (also known as programmed death ligand-1) found on cancer cells. By binding to PD-L1, durvalumab blocks the cancer cell from attaching to its corresponding PD-1 receptor on T-cells released by the immune system. When cancer cells are allowed to bind to T-cells via the “PD-1/PD-L1 pathway,” T-cells are prevented from attacking and killing cancerous mesothelial cells.
The interaction between durvalumab and the immune system is not considered chemotherapy or radiation therapy (both of which are recommended treatments prior to taking durvalumab). Instead of chemically killing cancer cells or bathing them with radiation, durvalumab encourages T-cells in the immune system to destroy the irregular cells around them.
Side Effects of Durvalumab
Due to the effects of durvalumab on the immune system, many patients taking the immunotherapy medication experience physical side effects. According to the American Cancer Society, the medication works “by removing the brakes from the body’s immune system,” whereby “the immune system then starts attacking other parts of the body.” As such, patients may experience common side effects like coughing, shortness of breath, fatigue, inflammation of the lungs (pneumonitis), upper respiratory tract infections, and/or skin rashes.
|Possible Side Effects of Durvalumab|
|Affected Area||Side Effect|
|Lungs||New or worsening cough, shortness of breath, and chest pain|
|Liver||Yellowing skin or whites of eyes, nausea and vomiting, pain on right side of abdomen, drowsiness, dark urine, bleed or bruise more easily, and reduced appetite|
|Intestines||Diarrhea, black or bloody stools, and stomach pain|
|Hormone glands||Headaches; extreme fatigue; weight gain or loss; dizziness or fainting; hair loss; constipation; nausea; vomiting; and changes in mood, behavior, memory, or sex drive|
|Kidneys||Reduced urine production, blood in urine, ankle swelling, and loss of appetite|
|Skin||Rash, itching, and blisters|
|Infection||Fever, cough, frequent urination, pain when urinating, and flu-like symptoms|
|Infusion reaction||Chills or shaking, itching or rash, flushed skin, shortness of breath, dizziness, fever, neck pain, and swelling of the face|
According to data published in the oncology journal The Lancet, less than 10% of patients with advanced mesothelioma live past five years from their date of diagnosis. The survival rate for malignant mesothelioma, the study estimates, is about one year. “New treatment options are clearly warranted,” said research authors.
In one recent study of durvalumab on patients with advanced small cell lung cancer, those taking the drug in addition to chemotherapy lived an average of three months longer than patients in the control group. Imfinzi®, the brand name version, received accelerated approval from the FDA for the treatment of certain cancers that had stopped responding to traditional treatment (including chemotherapy) based on encouraging results from a Phase 1/2 study.
Currently, durvalumab is involved in another clinical trial alongside tremelimumab testing the combination’s effectiveness in treating malignant pleural mesothelioma (also known as mesothelioma of the lungs). The Phase II clinical trial will measure the drugs’ safety and efficacy before moving on to test a larger group of patients (between 1,000 and 3,000 people) in Phase III. Clinical trials for new cancer treatments can take years before gaining approval from the FDA for use among the general population.
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How Much Does Durvalumab Cost?
Because of durvalumab’s status as an immunotherapy medication with the FDA, it is not available at a regular pharmacy for sale or pickup. Similar to chemotherapy drug cisplatin, durvalumab is only available for treatment through a doctor, hospital, or clinic and you must have a prescription to receive it. However, most health insurance programs provide benefits to cover a portion of the cost of cancer treatment medications.
In 2017, one Economist article about the rising cost of cancer medicines listed the price for a year’s worth of Imfinzi® treatment at $180,000. Other immunotherapy medications can range from $10,000 to $100,000 month. Covering immunotherapy treatment prices in addition to primary treatments like chemotherapy and radiation therapy can place an incredible burden on the patient and their caregivers.
Paying for Durvalumab Treatment
The cost of treatment can be as much as a family home, in many cities, according to recent data about cancer treatment prices. If you need help paying for mesothelioma treatment, get a free case evaluation to determine your eligibility for assistance and download our free mesothelioma guide for more information on legal aid, veteran funds, and symptom relief.
For information about adding durvalumab as an immunotherapy treatment option, talk to your doctor or someone on your cancer care team.