Durvalumab in cancer medicine: a comprehensive review

Introduction: The U.S. FDA has approved durvalumab for the treatment of advanced urothelial and non-small cell lung cancers. However, this immunotherapy agent is also being explored in other cancers. There is also ongoing research to better predict the responses to this drug. Areas covered: We summarize the literature regarding durvalumab pharmacology, safety and efficacy in several tumor types. We searched PubMed/Medline database from inception to 20 April 2019, performed a snowball method, and visited independent websites such as the U.S. FDA ( https://www.fda.gov ), ClinicalTrials.gov, among others. Expert opinion: Advanced phase clinical trials have shown benefit of durvalumab in advanced urothelial and non-small cell lung cancers, and suggest benefit in several other tumor types. This agent has a tolerable toxicity profile and seems more effective in patients with a higher PDL-1 expression, although this correlation is not perfect. An improved method to predict a response to durvalumab would be beneficial to best tailor therapy and minimize medical care costs. More research is needed to establish its efficacy in different disease stages and applicability in other tumor types. Hopefully, prospective, randomized trials of durvalumab, alone and/or in combination with other agents, will bring answers to these questions in the near future.