What cancer types are durvalumab indicated for?

Durvalumab/Durvalumab is a humanized anti-PD-L1 monoclonal antibody developed by AstraZeneca and used to modulate the immune system against a variety of solid tumors. It blocks the binding of PD-L1 to PD-1 or CD80, thereby enhancing the killing effect of T cells on tumor cells. It belongs to the immune checkpoint inhibitor family. In recent years, durvalumab has shown good anti-cancer potential in multiple clinical trials. It has been approved for the treatment of multiple types of cancer and is continuously expanding its indications.

In non-small cell lung cancer ( NSCLC), durvalumab is suitable for multiple stages of treatment. For patients with surgically resectable NSCLC (tumor size ≥4 cm or positive lymph nodes, and no EGFR or ALK gene mutations), durvalumab can be combined with platinum-based chemotherapy as neoadjuvant therapy, and then continued as a single agent as postoperative adjuvant therapy. This treatment strategy is based on the results of the AEGEAN study and helps to prolong disease-free survival. In patients with unresectable stage III NSCLC, durvalumab can also be used as maintenance therapy after concurrent chemoradiotherapy (cCRT) to significantly extend progression-free survival and overall survival. This indication was approved based on the PACIFIC study. In addition, durvalumab can also be combined with tremelimumab and platinum-containing chemotherapy for patients with metastatic NSCLC, especially those without EGFR or ALK sensitizing mutations, providing a new combination of immunity + chemotherapy + immunity.

In the treatment of small cell lung cancer (SCLC), the role of durvalumab has also become increasingly prominent. For limited-stage small cell lung cancer (LS-SCLC), it can be used as maintenance treatment after platinum-based chemotherapy and radiotherapy; while for extensive-stage small cell lung cancer (ES-SCLC), durvalumab can be combined with etoposide and cisplatin or carboplatin as a first-line treatment option. The CASPIAN study confirmed its advantage in extending overall survival, marking the first breakthrough of immunotherapy in ES-SCLC.

Durvalumab has also been expanded to the field of biliary tract cancer (BTC). The combination of gemcitabine and cisplatin for the first-line treatment of patients with locally advanced or metastatic biliary tract cancer is a direct result of the TOPAZ-1 study. Research shows that this combination regimen significantly improves the overall survival rate and progression-free survival of patients, bringing new hope for the treatment of malignant tumors of the biliary system.

In hepatocellular carcinoma (In the field of HCC), the combination therapy of durvalumab and temsilimumab has also been approved and is suitable for patients with unresectable HCC. This combination showed superior survival benefit in the HIMALAYA study, showed better treatment prospects than traditional sorafenib treatment, and became the first proven effective immune dual-antibody treatment strategy for HCC.

In addition, durvalumab is indicated for patients with mismatch repair deficient (dMMR) primary advanced or recurrent endometrial cancer. Its use in combination with carboplatin and paclitaxel, followed by single-agent maintenance therapy, provides a new treatment option for patients with advanced gynecological tumors. The establishment of this indication is an important manifestation of the expansion of immunotherapy to cancers derived from more tissues, and also marks the continuous improvement of durvalumab's status in precision medicine.

Reference materials:https://www.imfinzi.com/