Usage and dosage of durvalumab/Infinifer

Durvalumab/Infinifer (Durvalumab) is an anti-PD-L1 monoclonal antibody that restores the body's immune system's ability to recognize and attack tumor cells by blocking the binding of PD-L1 to the T cell receptor PD-1. It is one of the important drugs in modern immunotherapy. The drug is usually administered by intravenous infusion, which needs to be diluted and continued for more than 60 minutes to ensure even distribution and safety of the drug. The dosing regimen of durvalumab varies among different tumor types and treatment stages and needs to be individually adjusted based on patient weight and treatment goals.

For patients with resectable non-small cell lung cancer who weigh more than30 kg, the neoadjuvant treatment phase is usually combined with chemotherapy, once every three weeks, 1500 mg each time, for up to four cycles; in the postoperative adjuvant treatment phase, it is used as a single agent, once every four weeks, 1500 mg each time, for up to twelve cycles. For patients weighing less than 30 kilograms, the dose is calculated based on body weight, 20 mg per kilogram, and the number of cycles is the same as for patients with larger body weight. The principle of treatment is until disease progression, unacceptable toxicity, or maximum treatment duration.

For patients with unresectable stage III non-small cell lung cancer, after completing platinum-based chemotherapy and radiotherapy, patients weighing more than 30 kg can choose a dosage regimen of 10 mg/kg every two weeks or 1500 mg every four weeks, while those weighing less than 30 kg can choose a dosage regimen of 10 mg/kg every two weeks. The treatment duration can be up to twelve months, until disease progression or intolerable toxicity occurs. Patients with metastatic non-small cell lung cancer are usually treated with tremelimumab and platinum-containing chemotherapy in combination with tremelimumab and platinum-containing chemotherapy. Patients weighing more than 30 kg are given 1,500 mg once every three weeks. After four cycles of combined chemotherapy, they enter the single-agent maintenance phase, once every four weeks. At the same time, pemetrexed maintenance therapy is given based on histology. For patients weighing less than 30 kg, the dose is calculated at 20 mg per kilogram. The cycle schedule of combination chemotherapy and maintenance treatment is adjusted accordingly.

In patients with limited-stage and extensive-stage small cell lung cancer , durvalumab is also usually used in combination with platinum-based chemotherapy and radiotherapy. For patients weighing more than 30 kg, 1500 mg is given once every four weeks. Patients with extensive-stage patients enter the single-drug maintenance phase after combining etoposide and platinum-based chemotherapy. For patients weighing less than 30 kg, the dose is calculated based on body weight. The dosage cycle is adjusted every two weeks or every four weeks to ensure the balance between drug efficacy and tolerability.

For patients with cholangiocarcinoma, unresectable hepatocellular carcinoma and dMMR endometrial cancer, durvalumab is often used in combination with chemotherapy or immunotherapy. Adults weighing more than 30 kg are usually combined with chemotherapy every three weeks, followed by single-agent maintenance every four weeks. For those weighing less than 30 kg, the dose is adjusted to 20 mg per kilogram or a corresponding calculation method. The treatment period depends on the condition and tolerance.

Overall, the usage and dosage of durvalumab emphasizes individualization, weight adjustment, and combined treatment strategies. Its core principle is to maintain sustained and effective immune activation while controlling toxic and side effects. In clinical practice, doctors will formulate specific plans based on the patient's tumor type, weight, previous treatment status, and tolerance to ensure that the treatment is safe and effective. This precision medication not only embodies the concept of modern immunotherapy, but also provides diverse and adjustable treatment options for patients with different types of cancer.

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