[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Immune checkpoint inhibitors](https://durgical.com/en/pharmacology/classes/immune-checkpoint-inhibitors/) › Durvalumab

# Durvalumab

## Immune checkpoint inhibitors?

Immune checkpoint inhibitors

## High alert?

An error with this medicine can cause serious harm: double checks and protocols are used.

## Pregnancy: avoid?

Avoid in pregnancy. Can harm the fetus; a pregnancy test may be done before starting, contraception is used during treatment and for months after, and breastfeeding is avoided.

Human anti-PD-L1 antibody that releases the brake on T cells. For lung, bladder, biliary, liver and other cancers; side effects are immune attacks on organs.

Updated Nov 1, 2026

## Quick facts

**Group**
[Immune checkpoint inhibitors](https://durgical.com/en/pharmacology/classes/immune-checkpoint-inhibitors/)

**Target**
Programmed death-ligand 1 (PD-L1) on tumour and immune cells

**Used for**
Non-small cell lung cancer · Small cell lung cancer

**Key effects**
Tiredness · Constipation · Muscle or bone pain

**Monitor**
Thyroid · New cough or breathlessness · Stools

**ATC**
L01FF03

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◆**Programmed death-ligand 1 (PD-L1) on tumour and immune cells**Durvalumab

ⓘ The crystal shows the extracellular domain of human PD-L1 bound to the durvalumab Fab, which covers the face PD-L1 uses to bind PD-1.

**Target in 3D:** Programmed death-ligand 1 (PD-L1) on tumour and immune cells. PDB structure 5X8M (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/5X8M) · Drag to rotate · pinch to zoom

Many tumours display PD-L1, which binds PD-1 on T cells and switches them off. Durvalumab is a human IgG1 antibody that binds PD-L1 and blocks this contact, so cytotoxic T cells that reach the tumour stay active and can kill cancer cells. Because the same brake also protects healthy tissues, releasing it can let T cells attack normal organs.

- Durvalumab binds PD-L1 on tumour cells
- PD-L1 can no longer switch off T cells through PD-1
- T cells attack the tumour, and sometimes healthy organs

## Indications

- Non-small cell lung cancer: unresectable stage III after chemoradiation, around surgery, or metastatic with tremelimumab and chemotherapy (without EGFR or ALK changes). [Lung cancer →](https://durgical.com/en/conditions/lung-cancer/)
- Small cell lung cancer: limited stage after chemoradiation, or extensive stage first line with etoposide and a platinum drug. [Lung cancer →](https://durgical.com/en/conditions/lung-cancer/)
- Spread biliary tract cancer (cholangiocarcinoma, gallbladder cancer) with gemcitabine and cisplatin. [Cholangiocarcinoma (bile duct cancer) →](https://durgical.com/en/conditions/cholangiocarcinoma/)
- Unresectable hepatocellular carcinoma, with tremelimumab. [Hepatocellular carcinoma →](https://durgical.com/en/conditions/hepatocellular-carcinoma/)
- Muscle-invasive bladder cancer around surgery; mismatch repair-deficient endometrial cancer; resectable gastric or gastro-oesophageal junction cancer, with chemotherapy. [Bladder cancer →](https://durgical.com/en/conditions/bladder-cancer/)

## Adverse effects

### Common

- Tiredness, cough, shortness of breath
- Constipation, decreased appetite
- Swelling of the arms or legs
- Muscle or bone pain, trouble sleeping, hair loss

### Serious (rare, important)

- Immune pneumonitis: new cough, chest pain, breathlessness
- Immune colitis and hepatitis: diarrhoea, bloody stools, yellow skin, dark urine
- Endocrine damage: thyroid, adrenal, pituitary and new diabetes
- Immune nephritis, myocarditis, myositis, neuropathy, meningitis, eye inflammation and severe skin reactions
- Infusion reactions

## Contraindications

- No absolute contraindications in the label apart from hypersensitivity; see the warnings

## Key interactions

**Corticosteroids and other immunosuppressants**
May be needed to treat immune side effects; the team decides when to use them.

## What is monitored

- Thyroid, liver and kidney tests and blood glucose before and during treatment
- New cough or breathlessness (pneumonitis)
- Stools: number, blood, abdominal pain
- Vital signs during and shortly after the infusion

## Administration and safety

- Intravenous infusion by a doctor or nurse in a hospital or clinic; the patient is watched during and shortly after it.
- The infusion may be paused or stopped for a reaction, and treatment may be held for immune side effects.
- The patient receives the Medication Guide to read.

## Pregnancy and breastfeeding

Avoid in pregnancy. Can harm the fetus; a pregnancy test may be done before starting, contraception is used during treatment and for months after, and breastfeeding is avoided.

## Nursing care

- Ask about transplants (including cornea and stem cells), autoimmune disease and chest radiotherapy before starting.
- Teach that immune side effects can appear at any time, even after treatment ends, and must be reported early.
- Teach to report cough, diarrhoea, yellow skin, unusual headaches, thirst, dizziness, palpitations, muscle weakness or rash.
- Watch for chills, flushing, wheeze or back pain during the infusion.

## Pharmacokinetics

**Absorption**
Intravenous infusion over about an hour, every few weeks.

**Elimination**
Broken down like other IgG antibodies, by protein catabolism.

## Memory aid

DURVALUMAB blocks the LIGAND (PD-L1), not the receptor: -mab on the tumour side. Release the brake, and any organ can become a target ('-itis' everywhere).

## Test yourself

Think of the answer, then tap the question to see it.

## Does durvalumab bind PD-1 or PD-L1?

PD-L1, the ligand displayed by tumour cells.

## A patient on durvalumab develops a new cough and breathlessness. What must be suspected?

Immune-mediated pneumonitis.

## Which history should be asked about before starting durvalumab?

Organ or stem cell transplant, autoimmune disease and chest radiotherapy.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/durvalumab/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**High alert**
An error with this medicine can cause serious harm: double checks and protocols are used.

**Pregnancy: avoid**
Avoid in pregnancy. Can harm the fetus; a pregnancy test may be done before starting, contraception is used during treatment and for months after, and breastfeeding is avoided.

## Connections

## Related drugs 3

- [Atezolizumab](https://durgical.com/en/pharmacology/atezolizumab/)
- [Pembrolizumab](https://durgical.com/en/pharmacology/pembrolizumab/)
- [Nivolumab](https://durgical.com/en/pharmacology/nivolumab/)

## Related conditions 4

- [Lung cancer](https://durgical.com/en/conditions/lung-cancer/)
- [Cholangiocarcinoma (bile duct cancer)](https://durgical.com/en/conditions/cholangiocarcinoma/)
- [Hepatocellular carcinoma](https://durgical.com/en/conditions/hepatocellular-carcinoma/)
- [Bladder cancer](https://durgical.com/en/conditions/bladder-cancer/)

[← Back to the class: Immune checkpoint inhibitors](https://durgical.com/en/pharmacology/classes/immune-checkpoint-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Durvalumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a617030.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Durvalumab - NCI](https://www.cancer.gov/about-cancer/treatment/drugs/durvalumab) (National Cancer Institute (U.S.), 2026); [PD-L1 in complex with durvalumab](https://www.rcsb.org/structure/5X8M) (RCSB Protein Data Bank, 2017).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/durvalumab/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/durvalumab/