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This website is intended for UK Healthcare professionals only. Other UK residents please visit astrazeneca.co.uk
In the UK, only ~15% with stage III lung cancer will survive for 5 years or more after they have been diagnosed.1 By targeting immune checkpoints, IMFINZI (durvalumab) aims to improve survival rates in a curative intent setting for patients with stage III unresectable non-small cell lung cancer (NSCLC).2-4 IMFINZI as monotherapy is indicated for the treatment of locally advanced, unresectable non-small cell lung cancer (NSCLC) in adults whose tumours express PD-L1 on ≥ 1% of tumour cells and whose disease has not progressed following platinum-based chemoradiation therapy.8
Patients with programmed cell death ligand-1 (PD-L1)-positive lung cancer typically exhibit elevated levels of PD-L1 expression on tumour cells, underscoring the importance of PD-L1 as a predictive biomarker in lung cancer patients.6,7 Typically PD-L1 levels helps predict which patients are more likely to respond to immunotherapy in lung cancer.6,7
Adapted from IMFINZI SmPC. AstraZeneca Pharmaceuticals LP.1
APC, antigen-presenting cell; CD, cluster of differentiation; MHC, major histocompatibility complex; PD-1, programmed death receptor 1; PD-L1, programmed death ligand 1; TcR, T-cell receptor.
1. eMC. IMFINZI™ (durvalumab) Summary of Product Characteristics – UK. https://www.medicines.org.uk/emc/product/9495 (last accessed January 2025).
IMFINZI is a human immunoglobulin G1 kappa (IgG1κ) monoclonal antibody (mAb) that selectively blocks the interaction of PD-L1 with programmed cell death-1 (PD-1) and CD80.8
Some therapeutic mAbs utilise antibody dependent cell-mediated cytotoxicity (ADCC) for their anti-tumour efficacy, where immune cells kill target cells coated with antibodies.9,10
IMFINZI's mechanism of action does not rely on ADCC, and instead focuses on enhancing T-cell activity via PD-L1 blockade– offering a distinct approach in cancer immunotherapy for NSCLC.8
With IMFINZI, the selective blockade of the PD-1/PD-L1 and PD-L1/CD80 pathways leads to increased T-cell activation and enhanced antitumor immune responses in NSCLC patients undergoing PDL-1 immunotherapy.8
IMFINZI has demonstrated statistically significant efficacy in the PACIFIC clinical trials, including improvements to overall survival (OS) and progression-free survival (PFS) compared to placebo.2,3
The most common adverse reactions with Imfinzi monotherapy were cough/productive cough, diarrhoea, rash, pyrexia, upper respiratory tract infections, abdominal pain, pruritus, and hypothyroidism.8
Chemoradiotherapy (CRT) has direct cytotoxic effects and induces immunomodulatory changes prior to using IMFINZI.11-13
For instance, apoptotic cells release DAMPs, chemokines, and cytokines, triggering an immune response (antigen storm).12 Effector lymphocytes secrete cytotoxic molecules (e.g. perforins, granzymes) and engage death receptors via surface expression of Fas ligand (FasL) and TRAIL, mediating anti-tumor cytotoxicity.14
The radiotherapy aspect of CRT also induces a wide range of immunomodulatory effects that potentially influence the effectiveness of immunotherapies, such as IMFINZI, in lung cancer.11
Adapted from Figure 1. Daly et al. (2015).
CRT, chemoradiotherapy; MHC I, major histocompatibility complex I; PD-L1, programmed cell death-ligand-1.
After conducting a sub-group analysis in the PACIFIC clinical trial, PFS and OS benefits were greater in patients randomised within 14 days compared to patients randomised >14 days after their last radiation therapy, suggesting possible synergy between IMFINZI and radiation therapy.15
In preclinical models, certain chemotherapy treatments have demonstrated the ability to trigger ICD, enhancing the body's immune response against cancer cells.11 These chemotherapy-induced effects may complement and enhance the efficacy of combined CRT and immunotherapy in stage III unresectable NSCLC.11 Caution is advised while interpreting data from pre-clinicial models; clinical significance is unknown.
IMFINZI, a IgG1κ mAb, has a protein chemical structure and is primarily eliminated by protein catabolism via the reticuloendothelial system or through target-mediated disposition.16 The terminal half-life of IMFINZI is approximately 18 days based on baseline IMFINZI clearance.8
ADCC, antibody dependent cell-mediated cytotoxicity; APC, antigen-presenting cell; CRT, Chemoradiotherapy; CD, cluster of differentiation; DAMP, damage-associated molecular patterns; FasL, Fas ligand; ICD, immunogenic cell death; IgG1κ, immunoglobulin G1 κ light chain; IFN-γ, interferon-gamma; mAb, monoclonal antibody; MHC, major histocompatibility complex; NSCLC, non-small cell lung cancer; OS, overall survival; PD-1, Programmed Cell Death Protein 1; PD-L1, Programmed Cell Death Ligand 1; PFS, progression-free survival; TAA, tumour-associated antigen; TAM, tumour-associated macrophages; TcR, T-cell receptor; TME, tumour microenvironment; TRAIL, TNF-related apoptosis-inducing ligand.
GB-66550 | DOP: April 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
