AstraZeneca’s Imfinzi (durvalumab) is an FDA-approved immunotherapy drug for bladder and lung cancers. It helps the immune system attack cancer cells. Researchers are now testing Imfinzi in clinical trials to evaluate its potential for treating mesothelioma.
Written by: Karen Selby, RN | Medically Reviewed By Dr. Andrea Wolf | Edited By Amy Edel | Last Update: July 25, 2025
"Most helpful, steered us in the right direction for treatmen...." see more
Elaine C. - Mesothelioma Patient
"Because of their guidance, I was able to navigate getting my...." see more
Deanna B. - Daughter of a Mesothelioma Patient
"Hearing the news about my mother's diagnosis was heartbreaki...." see more
Danielle W. - Daughter of a Mesothelioma Patient
"My son Carlos was diagnosed with this terrible and unknown d...." see more
Martha M. - Mother of a Mesothelioma Patient
"Extremely communicative and helped my dad get an appointment...." see more
Sunni H. - Loved One of a Mesothelioma Patient
"Danielle DiPietro was an invaluable resource for me. Her sug...." see more
Deborah C. - Spouse of a Mesothelioma Patient
"I was very grateful and appreciative of Dr. Smart from The M...." see more
Kimberlin C. - Spouse of a Mesothelioma Patient
"In January of 2016, my husband was diagnosed with peritoneal...." see more
Gloria R. - Spouse of a Mesothelioma Patient
Imfinzi (durvalumab) is an immunotherapy drug that boosts the body’s natural immune system. It combines two types of immunotherapy known to show promise in treating mesothelioma: checkpoint inhibitors and monoclonal antibodies.
Monoclonal antibodies are lab-made proteins designed to work like your body’s natural immune system proteins. Checkpoint inhibitors target proteins that normally help keep the immune system from attacking healthy cells. Some cancer cells, including mesothelioma, use these checkpoint proteins to hide from the immune system. Imfinzi blocks these checkpoint proteins so the immune system stays active and can attack cancer cells more effectively.
While Imfinzi is approved for bladder and lung cancer treatment, and was granted Breakthrough Therapy Designation for non-small cell lung cancer, it’s not yet FDA-approved for mesothelioma. Researchers continue studying Imfinzi’s effectiveness in mesothelioma, and the immunotherapy drug is used only in clinical trials or occasionally off-label for this cancer.
| Durvalumab Information | |
|---|---|
| Name | Durvalumab |
| Alternate Names | Imfinzi, MEDI4736 |
| Manufacturer | AstraZeneca |
| Dosage | 10 mg/kg |
| Administration Route | IV |
| Active Ingredient | Durvalumab |
| Drug Class | Checkpoint inhibitor, monoclonal antibody |
| Medical Code | C9492 |
| Interacting Drug | Vaccines, vitamin E, zinc, cat’s claw, echinacea |
| Medical Studies | A phase 2 study of durvalumab in combination with tremelimumab in malignant pleural mesothelioma |
| FDA Warning | Pneumonitis, liver disease, colitis, kidney inflammation, endocrine gland disease, infection, infusion reactions, fetal harm |
Imfinzi targets PD-L1, a protein on cancer cells, to help fight them. Pleural mesothelioma cancer often produces high levels of this protein, making this mechanism especially important.
Imfinzi blocks PD-L1’s “stop signal.” It’s designed to protect healthy cells, but cancer cells can exploit it to hide. Blocking this stop signal keeps immune cells alert so they can find and destroy cancer. Doctors sometimes test tumors for PD-L1 to better predict how people will respond to treatment. But benefits can happen without high levels.
Recent clinical trials, including the phase III DREAM3R study, combined Imfinzi with chemotherapy for pleural mesothelioma. Participants receiving both treatments showed better response rates and longer progression-free survival compared to chemo alone.
Imfinzi is often combined with another checkpoint inhibitor, Imjudo (tremelimumab), which blocks a different immune checkpoint protein called CTLA-4. Researchers are actively studying this combination in clinical trials to evaluate its effectiveness in treating mesothelioma.
Imfinzi is approved for multiple types of lung cancer, many of which can be linked to asbestos exposure. It’s prescribed based on the specific type and stage of lung cancer, often in combination with other treatments.
FDA Approved Uses for Imfinzi
The ADRIATIC trial tested durvalumab as an extra treatment for more than 500 people with limited-stage SCLC who finished chemo and radiation. People who got durvalumab stayed cancer-free longer and lived much longer than those who received a placebo. After 3 years, 57% of people treated with durvalumab were still alive, compared to 48% given the placebo.
Durvalumab helped the immune system find and kill leftover cancer cells after standard treatment. Two years into the trial, 46% of the durvalumab group showed no signs of cancer returning, versus 34% with placebo. Durvalumab also extended the average survival time from 33 months to 56 months.
We’ll get you the best doctor for your diagnosis and schedule appointments with them quickly.
Find My DoctorDurvalumab continues to show promise as a treatment for mesothelioma, especially when combined with chemo. Recent and ongoing clinical trials have shown encouraging results, pointing toward a potential shift in first-line therapy for this rare and aggressive cancer.
The DREAM3R trial is a large phase III study testing if adding Imfinzi to standard chemo benefits people with advanced pleural mesothelioma. Results should come before February 2026. Another important study, the PrE0505 phase II trial, gave Imfinzi with platinum-pemetrexed chemo to people with untreated mesothelioma that can’t be removed with surgery. The study showed promising improvements in survival and response rates.
PrE0505 Phase II Trial Findings
Dr. Patrick Forde, director of the thoracic cancer clinical research program at Johns Hopkins Kimmel Cancer Center, said of the trial, “The survival for patients with epithelioid MPM exceeded two years. And some patients with epithelioid MPM who enrolled in the clinical trial continue to be free from tumor progression today.”
The Dana-Farber Cancer Institute began a phase II trial in April 2017 of Imfinzi and Imjudo for people with mesothelioma who couldn’t undergo surgery. Navy veteran Jim McWhorter participated and told us he initially saw his cancer stay stable for several months. But after a CT scan showed new tumor growth, he said he had to leave the trial to seek other options.
Jim was able to get into a clinical trial at Dana-Farber Cancer Institute in Boston, testing a combination of the immunotherapy drugs durvalumab and tremelimumab. For the first few months, the results were extremely positive. The cancer had stabilized.
Durvalumab side effects can range from mild to severe. In people taking Imfinzi for mesothelioma, the drug can stimulate the immune system, which may sometimes lead to mistakenly targeting healthy organs and tissues in addition to cancer cells.
Common Side Effects of Imfinzi
Other mild side effects can include low sodium levels in the blood and a reduced white blood cell count. Most mild to moderate side effects of durvalumab can be managed with medications your doctor can prescribe for you.
Some signs of severe infusion reactions from Imfinzi include chills or shaking, fever, dizziness, wheezing, shortness of breath or lightheadedness. Flushing, itching or rash, facial swelling and back or neck pain can also occur.
Serious Imfinzi Side Effects
If you experience any mild or severe side effects while taking Imfinzi for mesothelioma, contact your doctor right away. Prompt medical attention can help manage side effects effectively and prevent them from becoming more serious.
People with mesothelioma may be eligible to join clinical trials of Imfinzi if their cancer has returned after prior treatment and their tumors have high levels of PD-L1. This protein is found in about 20% to 40% of pleural mesothelioma cases. Clinical trials usually require a confirmed diagnosis, disease progression after standard treatments and good overall health.
In some cases, doctors may consider prescribing Imfinzi off-label for mesothelioma. This means using the drug outside its official FDA approvals based on the person’s condition and medical judgment.
Another option for accessing Imfinzi is through compassionate use programs. Also called expanded access, this allows people with serious illnesses who can’t join clinical trials and have no other treatment options to receive experimental drugs. Access usually requires approval from the drug manufacturer and the person’s doctor. Sometimes approval from regulatory agencies is also required. Those interested in compassionate use should discuss it with their healthcare team or a Patient Advocate to explore eligibility and how to apply.
Studies suggest that when combined with chemo or other immunotherapies like tremelimumab, Imfinzi can offer survival benefits for mesothelioma similar to or better than other options. This includes the FDA-approved combination of Opdivo and Yervoy. Imfinzi is mostly available through clinical trials and isn’t yet FDA-approved for mesothelioma. You should discuss specific options, eligibility and clinical trial access with your mesothelioma specialist to determine the most suitable immunotherapy approach for you.
Yes, Imfinzi may be an option for some mesothelioma patients if chemo is no longer effective. You should consult your oncologist about available clinical trials and whether Imfinzi-based immunotherapy could be an option.
Mesothelioma patients receiving Imfinzi, usually as part of a clinical trial, can expect treatment with regular intravenous infusions, often every 3 weeks and sometimes combined with chemo. Patients will have frequent check-ups, scans and blood tests to track their response and monitor side effects.
Many people experience a period of stable disease or tumor shrinkage, but individual results vary. The length of treatment depends on the response to side effects. Ongoing communication with your health care team is important to manage potential complications.
Mesothelioma patients typically receive Imfinzi through IV infusions every 3 or 4 weeks, often in combination with chemo for 4 to 6 months. Maintenance doses follow if the cancer remains controlled. Most clinical trials limit the total duration to about 1 year, but the exact length of treatment depends on how well the person responds and tolerates any side effects.
Your web browser is no longer supported by Microsoft. Update your browser for more security, speed and compatibility.
If you are looking for mesothelioma support, please contact our Patient Advocates at (855) 404-4592
The Mesothelioma Center at Asbestos.com has provided patients and their loved ones the most updated and reliable information on mesothelioma and asbestos exposure since 2006.
Our team of Patient Advocates includes a medical doctor, a registered nurse, health services administrators, veterans, VA-accredited Claims Agents, an oncology patient navigator and hospice care expert. Their combined expertise means we help any mesothelioma patient or loved one through every step of their cancer journey.
More than 30 contributors, including mesothelioma doctors, survivors, health care professionals and other experts, have peer-reviewed our website and written unique research-driven articles to ensure you get the highest-quality medical and health information.
My family has only the highest compliment for the assistance and support that we received from The Mesothelioma Center. This is a staff of compassionate and knowledgeable individuals who respect what your family is experiencing and who go the extra mile to make an unfortunate diagnosis less stressful. Information and assistance were provided by The Mesothelioma Center at no cost to our family.LashawnMesothelioma patient’s daughter
Selby, K. (2025, July 25). Imfinzi (Durvalumab). Asbestos.com. Retrieved July 31, 2025, from https://www.asbestos.com/treatment/immunotherapy/durvalumab/
Selby, Karen. "Imfinzi (Durvalumab)." Asbestos.com, 25 Jul 2025, https://www.asbestos.com/treatment/immunotherapy/durvalumab/.
Selby, Karen. "Imfinzi (Durvalumab)." Asbestos.com. Last modified July 25, 2025. https://www.asbestos.com/treatment/immunotherapy/durvalumab/.
Dr. Andrea Wolf is the Director of the New York Mesothelioma Program at Mount Sinai in New York City. She focuses on multidisciplinary treatment, clinical research, community outreach and education.
Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.
Please read our editorial guidelines to learn more about our content creation and review process.
