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Imfinzi® (Durvalumab) for Mesothelioma

Imfinzi® (durvalumab) is an immunotherapy drug that shows promise in treating mesothelioma. Cancer cells can hide from the immune system to avoid detection, but durvalumab stops this from happening. Doctors are testing durvalumab with other treatments and immunotherapies to help mesothelioma patients live longer. Learn how Mesothelioma Hope can help determine whether immunotherapy drugs like durvalumab are right for you or a loved one.

Fact-Checked and Updated by: Jenna Tozzi, RN

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What Is Imfinzi® (Durvalumab) for Mesothelioma?

Durvalumab, also known as Imfinzi, is a type of mesothelioma immunotherapy made by the company AstraZeneca.

Immunotherapy medications boost the body’s natural immune response to cancers like mesothelioma. Durvalumab belongs to a class of medications known as immune checkpoint inhibitors and works by targeting a protein called PD-L1, which is found on the surface of cancer cells.

The mesothelioma cells use PD-L1 to avoid destruction by T-cells (which the immune system makes to kill cancer). However, thanks to durvalumab, the T-cells can start fighting mesothelioma.

Key Facts on Durvalumab Immunotherapy for Mesothelioma

  • Brand name: Imfinzi
  • Combined treatments: Chemotherapy, surgery, and other immunotherapies
  • Delivery method: Intravenous (IV) infusion
  • Common side effects: Fatigue, nausea, numbness/tingling, and skin rashes
  • Life expectancy after therapy: 2 years or more when used with other treatments

Download our Free Immunotherapy Guide to learn how durvalumab and other types of mesothelioma immunotherapy drugs could help you.

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  • When it’s used
  • Types of therapies
  • What to expect

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How Does Imfinzi® (Durvalumab) for Mesothelioma Work?

Durvalumab works by preventing mesothelioma cells from hiding from the immune system’s T cells. Cancer cells have a protein called PD-L1, while T cells have another protein called PD-1.

T cells are naturally programmed to seek out and destroy cancer cells. However, mesothelioma cells bind their PD-L1 to the PD-1 on T cells, which prevents the T cells from killing them.

By blocking PD-L1, durvalumab interrupts this process so the T cells can destroy mesothelioma cells.

Did You Know?

Durvalumab has the potential to keep mesothelioma at bay for long periods of time. In the groundbreaking DREAM clinical trial, the medication stopped the disease from progressing for 6 months in nearly 60% of patients when used with chemotherapy. This is significant since mesothelioma is an aggressive cancer that spreads quickly.

When oncology (cancer) doctors combine durvalumab with other types of mesothelioma treatment, they can often destroy more of the cancer and potentially improve your life expectancy.

When Is Imfinzi (Durvalumab) Used for Mesothelioma?

Currently, you can only get durvalumab in clinical trials that are testing new mesothelioma treatments. These trials are studying different ways to use durvalumab that could improve patients’ mesothelioma prognosis (overall health outlook).

Durvalumab is being tested:

  • As a first-line treatment (initial one used)
  • As a second-line or third-line (follow-up) treatment
  • By itself
  • With other immunotherapies like tremelimumab (Imjudo®)
  • With other mesothelioma treatments like surgery or chemotherapy

Most clinical trials for durvalumab are only available to patients diagnosed with malignant pleural mesothelioma. This is the most common type of mesothelioma and forms in the lung lining (pleura).

That said, the recent NIBIT-MESO-1 study from 2021 used durvalumab and other therapies to treat both pleural and peritoneal mesothelioma, which forms in the abdominal lining (peritoneum).

Use our Free Doctor Match service to find specialists who can see if you’re a good candidate for immunotherapy.

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Imfinzi (Durvulamab) Immunotherapy Clinical Trials

Research on Imfinzi (durvalumab) for mesothelioma has been conducted through various clinical trials. Learn about what these trials found when testing durvalumab alone and in combination with other treatments.

DREAM Trial

  • Treatments tested: Durvalumab and chemotherapy
  • Type of mesothelioma: Pleural mesothelioma
  • Results: Durvalumab used with chemotherapy improved survival

The DREAM trial studied how durvalumab could help pleural mesothelioma patients live longer when administered alongside chemotherapy. It was conducted between 2016 and 2017.

This phase II study revealed that patients had an overall survival of 18.4 months on average when durvalumab and chemotherapy were combined, with a 2-year survival rate of 37%. This is the percentage of patients still alive after 2 years.

The trial also showed that durvalumab greatly slowed the spread of cancer, as 31 of the 54 patients in the study had a progression-free survival of 6 months.

PrE0505 Trial

  • Treatments tested: Durvalumab and chemotherapy
  • Type of mesothelioma: Pleural mesothelioma
  • Results: Durvalumab added to chemotherapy improved survival

The PrE0505 trial investigated if combining durvalumab with pemetrexed and cisplatin or carboplatin (commonly used chemotherapy drugs) could help patients with advanced pleural mesothelioma live longer.

Some patients in the study received both durvalumab with chemotherapy, while others only received chemotherapy. Patients treated with durvalumab had longer life expectancies and higher survival rates.

The results of the study were published in 2021. The average life expectancy for patients who received durvalumab was 20.4 months, while patients who received chemotherapy alone lived for 12.1 months.

The 2-year survival of patients treated with durvalumab was 44.2%, and the 6-month progression-free survival rate was 67.3%.

DREAM3R Trial

  • Treatments tested: Durvalumab, chemotherapy, and the immunotherapy drugs Opdivo and Yervoy
  • Type of mesothelioma: Pleural
  • Results: To be announced (study in process)

The phase III DREAM3R trial began in 2021 following the encouraging results from phase II.

In this study, pleural mesothelioma patients are being treated with one of the following:

  1. Durvalumab with cisplatin/carboplatin or pemetrexed
  2. Chemotherapy with pemetrexed and cisplatin/carboplatin (no immunotherapy)
  3. Opdivo (nivolumab) and Yervoy (ipilimumab), an immunotherapy combination recently approved by the U.S. Food and Drug Administration (FDA)

“Hopefully, with this study, we can get a definitive answer to the question of which is better: chemoimmunotherapy or ipilimumab and nivolumab.”
— Dr. Christina S. Baik, mesothelioma specialist at Fred Hutchinson Cancer Center

The study is expected to conclude in 2025, according to the National Cancer Institute (NCI). Over 200 pleural mesothelioma patients are taking part in the study.

Call (866) 608-8933 for help finding mesothelioma clinical trials testing immunotherapies like durvalumab that you may qualify to join.

Neoadjuvant Immunotherapy Trial

  • Treatments tested: Durvalumab, tremelimumab, and surgery
  • Type of mesothelioma: Pleural
  • Results: Combination immunotherapy before surgery led to improved life expectancy

This 2023 Baylor College of Medicine study compared the use of durvalumab alone to durvalumab and tremelimumab, another type of immunotherapy.

The immunotherapies were neoadjuvant, meaning they were administered before surgery to help shrink pleural mesothelioma tumors.

Patients who received durvalumab prior to surgery lived for 14.1 months. A specific median life expectancy wasn’t listed for patients who received the combination immunotherapy. However, researchers noted that these patients had a longer survival on average than those treated with only durvalumab.

NIBIT-MESO-1 Trial

  • Treatments tested: Durvalumab and tremelimumab
  • Types of mesothelioma: Pleural and peritoneal
  • Results: Combining immunotherapy led to improved survival

The 2021 NIBIT-MESO-1 trial investigated how patients with pleural or peritoneal mesothelioma could benefit from tremelimumab and durvalumab as a second-third or third-line treatment option.

Second-line or third-line treatments are used to help patients whose cancer has stopped responding to their first set of treatments.

Patients received doses of the immunotherapy drugs intravenously every 4 weeks. This was followed by 9 doses of durvalumab, with one dose administered every 4 weeks.

The median overall survival of patients was 16.5 months, with an average progression-free survival of 5.7 months. The 3-year survival rate was 20%.

Imfinzi Side Effects

When receiving Imfinzi (durvalumab) for mesothelioma, you may experience various side effects, which can range from mild to more severe.

Some common side effects of Imfinzi include:

  • Anemia
  • Constipation or diarrhea
  • Fatigue
  • Fever or chills
  • Headache
  • Hypertension
  • Loss of appetite
  • Muscle or joint pain
  • Nausea and vomiting
  • Shortness of breath
  • Skin rash or itching
  • Swelling of limbs

Some patients have reported more serious side effects of Imfinzi, such as tinnitus (chronic ringing in the ears) and hearing loss, hepatitis, and minor heart attacks.

Your oncologists (cancer doctors) will closely monitor you as you receive durvalumab and other mesothelioma treatments and manage any side effects that come up along the way.

Get our Free Immunotherapy Guide to learn more about possible side effects and how to manage them.

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What to Expect When Getting Imfinzi® (Durvalumab) for Mesothelioma

Every one’s treatment plan is different, but there are some general things you can expect when getting Imfinzi immnotherapy through a clinical trial. Learn more about the process below.

1. Durvalumab Infusions

A nurse adjusts an intravenous drip

When combined with chemotherapy, durvalumab is typically administered through an IV in cycles lasting 3-4 weeks with a rest period in between each session.

Patients only go through a set number of treatment cycles in most clinical trials. That said, in some studies like the DREAM trial, patients can continue to get infusions for up to a year if their cancer responds to treatment.

2. Monitoring of Cancer Response and Any Side Effects

Your health care team will monitor how your cancer responds to Imfinzi how long this response lasts, and if you develop any side effects or adverse events that need to be addressed.

Your medical team can adjust your mesothelioma treatment plan at any time to ensure you get the care you need while reducing the risk of complications.

3. Continued Monitoring and Treatment

Following durvalumab treatments, your doctors can recommend next steps and other therapies that could help you live longer with this cancer.

Doctors often combine Imfinzi with other mesothelioma treatments, which is an approach known as multimodal therapy. Your doctor may also recommend follow-up infusions depending on how your cancer responds to Imfinzi.

How to Access Imfinzi® (Durvalumab) for Mesothelioma

Imfinzi is currently available only in clinical trials for mesothelioma patients, which cost nothing to join.

That said, not every mesothelioma patient can receive durvalumab for mesothelioma, since clinical trials can only recruit a certain number of patients who meet a specific set of criteria.

Did You Know?

The PrE0505 and DREAM trials were specifically designed for pleural mesothelioma patients who hadn’t gotten any prior treatments and whose cancer was unresectable, meaning it couldn’t be removed with surgery.

Connect with a Patient Advocate now at (866) 608-8933 to get help finding a mesothelioma clinical trial for durvalumab near you. We can also help you pursue financial assistance to cover  medical treatment, travel costs, and any other expenses.

Learn if Imfinzi Is Right for You

Clinical trials testing Imfinzi (durvalumab) for mesothelioma continue to show this immunotherapy drug is an effective treatment option for many patients.

Durvalumab for mesothelioma can:

  • Boost overall life expectancy, in some cases by several years
  • Help early-stage and late-stage patients who have pleural or peritoneal mesothelioma
  • Work in combination with other treatments like surgery and chemotherapy

Wondering if this medication could help you or a loved one? Mesothelioma Hope can help you find clinical trials for Imfinzi and other immunotherapies. We’re here to walk with you through every step of your cancer journey with personalized medical guidance, financial assistance, and supportive care.

Download our Free Immunotherapy Guide or call (866) 608-8933 to connect with our team today.

Imfinzi (Durvalumab) Immunotherapy for Mesothelioma FAQs

Is durvalumab chemotherapy or immunotherapy?

Durvalumab is a type of immunotherapy for mesothelioma. It works by blocking proteins on cancer cells called PD-L1, which the cancer normally uses to avoid being killed by T cells.

Durvalumab is often paired with chemotherapy drugs to treat patients with pleural mesothelioma. Using all three therapies together has shown to help patients live longer than just using standard chemotherapy.

Does durvalumab work to treat mesothelioma?

Yes. Durvamlumab has shown promising results in clinical trials for treating malignant mesothelioma.

The recent PrE0505 trial showed that pleural mesothelioma patients lived for nearly two years on average when treated with durvalumab and chemotherapy. These treatments also stopped the cancer from spreading for 6 months in almost 70% of patients.

The ongoing DREAM3R trial, which is scheduled to finish in 2025, will give us a better idea of how effective durvalumab is in treating mesothelioma.

What cancers does Imfinzi treat?

Imfinzi can treat both pleural and peritoneal mesothelioma, as seen in recent clinical trials.

It is also approved by the U.S. Food and Drug Administration (FDA) to treat:

  • Biliary tract cancer
  • Non-small cell lung cancer (NSCLC)
  • Small cell lung cancer (SCLC)

How long do side effects from Imfinzi last?

It varies depending on factors such as dosage, the length of treatment, and your overall health.

While some side effects may resolve shortly after completing treatment, others may persist for weeks or months.

Always make sure to promptly report any side effects of Imfinzi to your mesothelioma doctor so they can find ways to help manage them.

How long can you take Imfinzi?

When given intravenously with other treatments like chemotherapy, Imfinzi infusions are usually completed over the course of several months.

In some cases, treatment may continue for as long as it helps keep your mesothelioma cancer from spreading and you aren’t suffering severe side effects.

Your mesothelioma doctor can give you a better idea as to how long you’ll receive durvalumab mesothelioma treatments.

Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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References
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  3. Barbor, M. (2023, September 10). Phase III Trial Reports Chemoimmunotherapy Is Superior to Chemotherapy Alone in Malignant Pleural Mesothelioma. Retrieved April 25, 2024, from https://ascopost.com/issues/september-10-2023/phase-iii-trial-reports-chemoimmunotherapy-is-superior-to-chemotherapy-alone-in-malignant-pleural-mesothelioma/
  4. Calabro, L., et al. (2021, April 9). Tremelimumab plus durvalumab retreatment and 4-year outcomes in patients with mesothelioma: a follow-up of the open label, non-randomised, phase 2 NIBIT-MESO-1 study. Retrieved April 25, 2024, from https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00043-6/abstract
  5. Forde, P., et al. (2021, November 8). Durvalumab with platinum-pemetrexed for unresectable pleural mesothelioma: survival, genomic and immunologic analyses from the phase 2 PrE0505 trial. Retrieved April 25, 2024, from https://www.nature.com/articles/s41591-021-01541-0
  6. Forde, P. (2021, May 28). DREAM3R: Durvalumab with chemotherapy as first-line treatment in advanced pleural mesothelioma—A phase 3 randomized trial. Retrieved April 25, 2024, from https://ascopubs.org/doi/10.1200/JCO.2021.39.15_suppl.TPS8586
  7. Lee, H., et al. (2023, February 01). A Phase II Window of Opportunity Study of Neoadjuvant PD-L1 versus PD-L1 plus CTLA-4 Blockade for Patients with Malignant Pleural Mesothelioma. Retrieved April 25, 2024, from https://www.mdpi.com/2072-6694/15/24/5787
  8. Mayo Clinic. (2024, February 1). Durvalumab (Intravenous Route). Retrieved April 25, 2024, from https://www.mayoclinic.org/drugs-supplements/durvalumab-intravenous-route/side-effects/drg-20406270?p=1
  9. National Cancer Institute. (n.d.). DuRvalumab With chEmotherapy as First Line treAtment in Advanced Pleural Mesothelioma. Retrieved April 25, 2024, from https://www.cancer.gov/research/participate/clinical-trials-search/v?id=NCI-2021-01459&r=1
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  11. PrECOG, LLC. (2023, December 1). DuRvalumab With chEmotherapy as First Line treAtment in Advanced Pleural Mesothelioma (DREAM3R). Retrieved April 25, 2024, from https://clinicaltrials.gov/study/NCT04334759?cond=Mesothelioma&term=DREAM3R&rank=1
    Retrieved April 25, 2024, from https://aacrjournals.org/clincancerres/article/29/3/548/716119/A-Phase-II-Window-of-Opportunity-Study-of
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