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IMFINZI (durvalumab), a human monoclonal antibody targeting PD-L1, is a key component of the AEGEAN regimen, which incorporates perioperative immunotherapy with neoadjuvant platinum-based chemotherapy for patients with staging and resectable NSCLC (stage IIA to IIIB N2). By binding to PD-L1, IMFINZI inhibits its interaction with PD-1 and CD80, enhancing antitumour immune responses and increases T-cell activation. This mechanism addresses the immunosuppressive environment commonly observed in NSCLC, which can limit the ability of the immune system to mount an effective antitumor response.2
The combination of IMFINZI with neoadjuvant platinum-based chemotherapy offers a complementary approach to treatment. Chemotherapy can reduce tumour volume while inducing immunogenic cell death, which releases tumour antigens that may enhance the immune response initiated by IMFINZI. This treatment strategy is designed to engage the immune system both preoperatively and postoperatively, with the goal of addressing residual disease.2–5
Adapted from Krishnamoorthy M et al. J Natl Cancer Inst 2021 and Heymach JV et al. N Engl J Med 2023.7,8
CT – chemotherapy; IO – immuno-oncology; PD-L1 – programmed death-ligand 1.
CT induces tumour cell death and antigen release, priming the immune system to activate T-cells to recognise these antigens and enhance the adaptive immune system's anti-tumour response. CT provides initial tumour control, but tumour cells exploit immune checkpoint pathways to evade the immune response and suppress anti-tumour activity.2,9–15
IMFINZI is a human IgG1κ mAb that binds to the PD-L1,2 which is commonly expressed on tumour cells and immune cells within the tumour microenvironment.
The binding of PD-L1 with the PD-1 receptor on T-cells induces
T-cell exhaustion, impairing their functional activity16–18
IMFINZI blocks PD-L1 from binding to PD-1, relieving T-cell inhibition and enhancing anti-tumour immune responses. Combined with chemotherapy, IMFINZI may reduce tumour burden, aiming to eradicate viable tumour cells before surgery (i.e. ‘neoadjuvant’ therapeutic approach).2,15,16,19,20
Following neoadjuvant therapy, tumour resection, such as lobectomy, is performed. Margins are assessed for completeness, and pathological evaluation determines if pCR has been achieved. However, despite complete resection, recurrence may remain a concern due to residual cancer cells or micrometastases.20–26
Adjuvant immunotherapy is intended to address micrometastases and recurrence. Post-surgical IMFINZI aims to restore T-cell function by blocking PD-L1/PD-1 interaction, enhancing anti-tumour immunity working to eliminate residual cancer cells.2,16,19,20,25
Combining neoadjuvant and adjuvant therapeutic approaches allows tumours to be treated before and after surgery. Neoadjuvant IMFINZI with chemotherapy (i.e. administered before surgery with chemotherapy) uses the tumour to prime antitumour immune response and potentially reduce tumour size. Adjuvant IMFINZI (i.e. administered after surgery without chemotherapy) has the potential to address tumour cells that may remain after surgery and may increase T-cells that can recognise and help eliminate micrometastases.7,8,20,25
CT – chemotherapy; Ig – immunoglobulin; mAb – monoclonal antibody; NSCLC – non-small cell lung cancer; pCR – pathological complete response; PD-1 – programmed cell death protein; PD-L1 – programmed death-ligand 1.
Discover more about the AEGEAN study design and efficacy outcomes
Get to know the AEGEAN safety profile
Learn more about the dosing details in the AEGEAN Regimen
GB-65616 | DOP: July 2025
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to AstraZeneca by visiting https://contactazmedical.astrazeneca.com/ or by calling 0800 783 0033.
This website was created for UK HCPs and has been designed to provide information to educate, empower and enable them in the great work they are doing for patients across a range of therapy areas. This website is intended for doctors, nurses, and pharmacists in the UK. Other UK residents please visit astrazeneca.co.uk.
GB-74216| DOP : February 2026
