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PD-L1 inhibition

CompoundDurvalumab

Area under investigation

Advanced solid tumors, BRCAm or PALB2m breast cancer, BTCs, Esophageal cancer, Gastric cancer, HCC, Metastatic urothelial carcinoma, Muscle-invasive bladder cancer, Non-muscle-invasive bladder cancer, NSCLC, RCC, SCLC, TNBC

Scientific PillarImmuno-Oncology

Target Overview

PD-L1 is a cell-surface protein that binds to the receptors PD-1 and CD80 on activated T cells, B cells, and other myeloid cells. PD-L1 binding to PD-1 on activated T cells has been found to interfere with T-cell proliferation and to inhibit immune responses.1 Overexpression of PD-L1 on cancer cells and solid tumors may allow these cells to avoid immune detection and elimination.2

Compound Overview

Durvalumab is an anti-PD-L1 mAb designed to bind PD-L1 and reduce the interaction between PD-L1 and its receptors. Durvalumab is being clinically evaluated in NSCLC, SCLC, UC, and various other solid tumors.

Mechanism of Action

  • Mechanism of Action
  • Mechanism of Action

Figures adapted from MedImmune Oncology Pipeline: Durvalumab, targeting PD-L1. ©2013 MedImmune, LLC. 11326A. AstraZeneca; 264701, May 2013.

References

1. Sznol M, Chen L. Clin Cancer Res. 2013;19(5):1021-1034.  2. Creelan BC. Cancer Control. 2014;21(1):80-89.

Target Overview

PD-L1 is a cell-surface protein that binds to the receptors PD-1 and CD80 on activated T cells, B cells, and other myeloid cells. PD-L1 binding to PD-1 on activated T cells has been found to interfere with T-cell proliferation and to inhibit immune responses.1 Overexpression of PD-L1 on cancer cells and solid tumors may allow these cells to avoid immune detection and elimination.2

Compound Overview

Durvalumab is an anti-PD-L1 mAb designed to bind PD-L1 and reduce the interaction between PD-L1 and its receptors. Durvalumab is being clinically evaluated in NSCLC, SCLC, UC, and various other solid tumors.

Mechanism of Action

  • Mechanism of Action
  • Mechanism of Action

Figures adapted from MedImmune Oncology Pipeline: Durvalumab, targeting PD-L1. ©2013 MedImmune, LLC. 11326A. AstraZeneca; 264701, May 2013.

References

1. Sznol M, Chen L. Clin Cancer Res. 2013;19(5):1021-1034.  2. Creelan BC. Cancer Control. 2014;21(1):80-89.

Clinical trial information


Select trial for more information

Area under investigation=true,Advanced solid tumors,BTCs,Esophageal cancer,Gastric cancer,NSCLC,SCLC,TNBC

ADRIATIC trial overview

Tumor

Limited stage SCLC not progressed following cCRT

Trial Identifier

NCT03703297

Phase

III

Regimen

Durvalumab; durvalumab + tremelimumab; placebo

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ARTEMIDE-Biliary02 trial overview

Tumor

Advanced BTC including intra-hepatic or extra-hepatic CCA and GBC

Trial Identifier

NCT07221253

Phase

III

Regimen

Rilvegostomig + gemcitabine/cisplatin; durvalumab + gemcitabine/cisplatin

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AVANZAR trial overview

Tumor

Advanced/metastatic NSCLC without actionable genomic alterations

Trial Identifier

NCT05687266

Phase

III

Stage

Advanced/metastatic NSCLC, 1L

Regimen

Dato-DXd + durvalumab + carboplatin; histologic-specific therapy (pembrolizumab + CT)

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DESTINY-BTC01 trial overview

Tumor

Advanced HER2-expressing BTCs, 1L

Trial Identifier

NCT06467357

Phase

III

Regimen

T-DXd  + rilvegostomig; T-DXd; gemcitabine + cisplatin + durvalumab

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fam-trastuzumab deruxtecan-nxki in US only; trastuzumab deruxtecan in other regions of world.

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DESTINY-Gastric03 trial overview

Tumor

HER2-expressing advanced/metastatic gastric/GEJ and esophageal adenocarcinoma

Trial Identifier

NCT04379596

Phase

Ib/II

Stage

Advanced

Regimen

T-DXd ± (chemotherapy or durvalumab or pembrolizumab); T-DXd + chemotherapy + (durvalumab or pembrolizumab); T-DXd + volrustomig + chemotherapy; T-DXd + rilvegostomig + chemotherapy

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fam-trastuzumab deruxtecan-nxki in US only; trastuzumab deruxtecan in other regions of world.

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DESTINY-Lung03 trial overview

Tumor

Unresectable locally advanced/metastatic non-squamous HER2 overexpressing NSCLC

Trial Identifier

NCT04686305

Phase

Ib

Stage

Metastatic, ≥1L

Regimen

T-DXd + durvalumab + (cisplatin/carboplatin/pemetrexed); T-DXd; T-DXd + volrustomig ± carboplatin; T-DXd + rilvegostomig ± carboplatin

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fam-trastuzumab deruxtecan-nxki in US only; trastuzumab deruxtecan in other regions of world.

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KUNLUN trial overview

Tumor

Locally advanced, unresectable esophageal squamous cell carcinoma

Trial Identifier

NCT04550260

Phase

III

Regimen

Durvalumab + definitive cCRT; placebo + definitive cCRT

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NeoCOAST-2 trial overview

Tumor

Resectable stage IIA to IIIB NSCLC (EGFR/ALK wild-type)

Trial Identifier

NCT05061550

Phase

II

Stage

Resectable disease (IIA to IIIB)

Regimen

Oleclumab + durvalumab + PtCh; monalizumab + durvalumab + PtCh; volrustomig (dose exploration) + PtCh; Dato-DXd + durvalumab + single agent platinum; AZD0171 + durvalumab + PtCh; rilvegostomig + PtCh; Dato-DXd + rilvegostomig + single agent platinum

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PACIFIC-4 trial overview

Tumor

Unresected Stage I/II, lymph node-negative NSCLC including tumors harboring a sensitizing EGFR mutation

Trial Identifier

NCT03833154

Phase

III

Stage

Unresected Stage I-II

Regimen

SBRT + placebo; SBRT + durvalumab; SBRT followed by osimertinib

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PACIFIC-9 trial overview

Tumor

Unresectable stage III NSCLC not progressed following definitive platinum-based cCRT

Trial Identifier

NCT05221840

Phase

III

Stage

Unresectable Stage III

Regimen

Durvalumab + oleclumab; durvalumab + monalizumab; durvalumab + placebo

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SubQ (NCT07391670) trial overview

Tumor

Solid tumours including NSCLC, HCC or LS-SCLC​

Trial Identifier

NCT07391670

Phase

I

Regimen

Durvalumab + rHu SC, durvalumab IV, tremelimumab IV

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TROPION-Breast03 trial overview

Tumor

TNBC (Stage I-III) who have residual invasive disease in the breast and/or axillary lymph nodes at surgical resection following neoadjuvant systemic therapy

Trial Identifier

NCT05629585

Phase

III

Stage

Stage I-III

Regimen

Dato-DXd ± durvalumab; investigator's choice of therapy (capecitabine or pembrolizumab or capecitabine + pembrolizumab)

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TROPION-Breast04 trial overview

Tumor

Histologically confirmed Stage II or III primary invasive TNBC or HR-low/HER2- BC

Trial Identifier

NCT06112379

Phase

III

Stage

Stage II-III

Regimen

Neoadjuvant Dato-DXd + durvalumab followed by adjuvant durvalumab ± olaparib (if gBRCAm) or CT; neoadjuvant pembrolizumab + CT followed by adjuvant pembrolizumab ± olaparib or capecitabine

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TROPION-Breast05 trial overview

Tumor

Locally recurrent inoperable or metastatic PD-L1-positive TNBC not previously treated with chemotherapy or targeted systemic anticancer therapy in this setting

Trial Identifier

NCT06103864

Phase

III

Stage

Stage IV

Regimen

Dato-DXd + durvalumab; investigator's choice of CT (paclitaxel, nab-paclitaxel, or gemcitabine + carboplatin) with pembrolizumab; Dato-DXd monotherapy

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TROPION-Lung04 trial overview

Tumor

Advanced/metastatic NSCLC without actionable genomic alterations and with/without previous treatment

Trial Identifier

NCT04612751

Phase

Ib

Stage

Advanced/metastatic NSCLC

Regimen

Dato-DXd + durvalumab ± carboplatin; Dato-DXd + rilvegostomig ± carboplatin; Dato-DXd + sabestomig

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Abbreviations

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  • 1L

    first line

  • 2L

    second line

  • 3L

    third line

  • aBTC

    Advanced Biliary Tract Cancer

  • ADA

    anti-drug antibody

  • AE

    adverse event

  • AESI

    adverse event of special interest

  • AJCC

    American Joint Committee on Cancer

  • AJCC v7

    American Joint Committee on Cancer version 7

  • ALK

    anaplastic lymphoma kinase

  • ALT

    alanine aminotransferase

  • anti-HBc

    anti–hepatitis B core antibody

  • AoV

    ampulla of Vater

  • APF12

    alive and progression free survival at 12 months

  • AST

    aspartate aminotransferase

  • BCC

    basal cell carcinoma

  • BCG

    Bacillus Calmette-Guérin (biologic)

  • BCLC

    Barcelona Clinic Liver Cancer

  • BICR

    blinded independent central review

  • BID

    twice daily

  • BOR

    best overall response

  • BRAF

    v-raf murine sarcoma viral oncogene homolog B1

  • BRCAm

    BRCA mutated

  • BTCs

    biliary tract cancers

  • CCA

    Cholangiocarcinoma

  • cCRT

    concurrent chemoradiation therapy

  • CD80

    cluster of differentiation 80

  • CIS

    carcinoma in situ

  • Cmax

    maximum observed plasma concentration of a drug

  • CNS

    central nervous system

  • CR

    complete response

  • CRR

    complete response rate

  • CRT

    chemoradiotherapy

  • cStage

    clinical stage

  • CT

    chemotherapy

  • cTACE

    conventional transarterial chemoembolization

  • CTCAE

    Common Terminology Criteria for Adverse Events

  • CTCAE v.5

    Common Terminology Criteria for Adverse Events version 5

  • Ctrough

    Lowest observed concentration of study drug before the next dose is administered

  • Ctrough

    Trough Plasma Concentration

  • CTLA-4

    cytotoxic T–lymphocyte-associated antigen 4

  • D

    durvalumab

  • Dato-DXd

    datopotamab deruxtecan

  • DCR

    disease control rate

  • dCRT

    definitive chemoradiation therapy

  • DDFS

    distant disease-free survival

  • DEB-TACE

    drug-eluting bead-TACE

  • DFS

    disease-free survival

  • DNA

    deoxyribonucleic acid

  • DoR

    duration of response

  • DoT

    duration of treatment

  • EBV

    Epstein-Barr virus

  • eCCA

    extrahepatic cholangiocarcinoma

  • ECOG

    Eastern Cooperative Oncology Group

  • ECOG PS

    Eastern Cooperative Oncology Group Performance Score

  • EFS

    event-free survival

  • EGFR

    epidermal growth factor receptor

  • EGFRm

    epidermal growth factor receptor mutation

  • EORTC

    European Organization for Research and Treatment of Cancer

  • EORTC QLQ-C30

    European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire

  • EORTC QLQ-NMIBC24

    European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Non-Muscle-Invasive Bladder Cancer 24

  • EP

    carboplatin or cisplatin + etoposide

  • EQ-5D-5L

    EuroQol-5 Dimensions-5 Levels

  • ES-SCLC

    extensive stage small-cell lung cancer

  • ESCC

    esophageal squamous cell carcinoma

  • EV

    enfortumab vedotin

  • FACT-BL

    functional assessment of cancer therapy-bladder

  • FH

    fumarate hydratase

  • FIGO

    International Federation of Gynecology and Obstetrics

  • FKSI

    Functional Assessment of Cancer Therapy-Kidney Symptom Index

  • FLOT

    fluorouracil, leucovorin, oxaliplatin and docetaxel

  • GBC

    gallbladder cancer

  • GEJ

    gastroesophageal junction

  • Gem-Cis

    gemcitabine and cisplatin

  • GI

    gastrointestinal

  • GHS

    global health status

  • HBcAb

    hepatitis B core antibody

  • HBsAg

    HBV surface antigen

  • HBV

    hepatitis B virus

  • HCC

    hepatocellular carcinoma

  • HCV

    hepatitis C virus

  • HDV

    hepatitis D virus

  • HIV

    human immunodeficiency virus

  • HNSCC

    head and neck squamous cell carcinoma

  • HRQoL

    health-related quality of life

  • I

    induction

  • IASLC

    International Association For The Study Of Lung Cancer

  • iCCA

    intrahepatic cholangiocarcinoma

  • ICR

    independent central review

  • ICT

    investigator's choice therapy

  • iDFS (IDFS)

    invasive disease-free survival

  • IHC

    immunohistochemistry

  • ILD

    interstitial lung disease

  • imAEs

    immune-mediated adverse events

  • IMP

    investigational medicinal product

  • IP

    investigational product

  • IRRs

    infusion-related reactions

  • ITT

    intention to treat

  • IV

    intravenous

  • IVES

    intravesical

  • KEAP1

    Kelch-like ECH-associated protein 1

  • KRAS

    Kirsten rat sarcoma viral oncogene homolog

  • LRT

    locoregional treatment

  • LS-SCLC

    limited-stage small cell lung cancer

  • M

    maintenance

  • M1

    distant metastasis-cancer has spread to other parts of the body

  • mAb

    monoclonal antibody

  • mCRPC

    metastatic castration-resistant prostate cancer

  • MET

    hepatocyte growth factor receptor

  • MHC

    major histocompatibility complex

  • MIBC

    muscle invasive bladder cancer

  • MOA

    mechanism of action

  • MPR

    major pathologic response

  • MRD+

    minimal residual disease positive

  • mRECIST

    modified Response Evaluation Criteria in Solid Tumors

  • MRI

    magnetic resonance imaging

  • MSS-CRC

    microsatellite stable-colorectal cancer

  • NEC

    large cell neuroendocrine carcinoma

  • NMIBC

    non-muscle-invasive bladder cancer

  • NSCLC

    non-small cell lung cancer

  • NTRK

    neurotrophic tyrosine receptor kinase

  • OC

    ovarian cancer

  • OD

    once daily

  • ORR

    overall or objective response rate

  • OS

    overall survival

  • OS-12

    overall survival at 12 months

  • OS-24

    overall survival at 24 months

  • OTRR

    objective tumor response rate

  • PALB2m

    partner and localizer of BRCA2 gene mutated

  • PCI

    prophylactic cranial irradiation

  • pCR

    pathological complete response

  • PD

    progressive disease

  • PD-1

    programmed cell death-1

  • PD-L1

    programmed cell death ligand-1

  • PD-L2

    programmed cell death ligand-2

  • PDC

    platinum doublet chemotherapy

  • PFS

    progression-free survival

  • PFS-12

    progression-free survival at 12 months

  • PFS-18

    progression-free survival at 18 months

  • PFS2

    time to second progression or death

  • PFS24

    PFS at 24 months from randomization

  • PK

    pharmacokinetics

  • PO

    per oral

  • PORT

    post-operative radiation therapy

  • PR

    partial response

  • PRAEs

    possibly related to treatment adverse events

  • pRCC

    papillary renal cell carcinoma

  • PRO

    patient-reported outcomes

  • PRO-CTCAE

    Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events

  • PS

    phosphatidylserine

  • PtCh

    platinum-based chemotherapy

  • PVT

    portal vein thrombosis

  • PVTT

    portal vein tumor thrombosis

  • Q*W

    every * weeks

  • Q28

    every 28

  • Q3W

    every 3 weeks

  • Q4W

    every 4 weeks

  • QD

    once daily

  • QLQ-BIL21

    21-item Cholangiocarcinoma and Gallbladder Cancer Quality of Life Questionnaire

  • QLQ-C30

    Quality of life Questionnaire-C30

  • QnW

    every n weeks

  • QoL

    quality of life

  • R

    randomization

  • RCC

    renal cell carcinoma

  • RECIST

    Response Evaluation Criteria in Solid Tumors

  • RECIST v1.1

    Response Evaluation Criteria in Solid Tumors version 1.1

  • RET

    rearranged during transfection

  • RFS

    recurrence-free survival

  • RFS2

    time from randomization to recurrence on next therapy

  • RFS24

    proportion of recurrence-free survival at 24 months

  • RFS36

    proportion of recurrence-free survival at 36 months

  • rHu

    recombinant human hyaluronidase

  • RNA

    ribonucleic acid

  • RT

    radiotherapy

  • SAE

    serious adverse event

  • SBRT

    stereotactic body radiation therapy

  • SC

    subcutaneous

  • SCC

    squamous cell carcinoma

  • SCLC

    small cell lung cancer

  • SCRT

    short course radiation therapy

  • sCRT

    sequential chemoradiation therapy

  • SD

    stable disease

  • SLE

    systemic lupus erythematosus

  • SoC

    standard of care

  • STK11

    serine/threonine kinase 11

  • STRIDE

    Single Tremelimumab Regular Interval Durvalumab

  • T

    tremelimumab

  • TACE

    transarterial chemoembolization

  • TB

    tuberculosis

  • tBRCAm

    tumor BRCA mutated

  • TC

    tumor cell

  • TCC

    transitional cell carcinoma

  • TCR

    T-cell receptor

  • TDT

    time to discontinuation or death

  • TEAE

    treatment emergent adverse event

  • TFST

    time to first subsequent therapy

  • TIGIT

    T-cell immunoreceptor with immunoglobulin and ITIM domains

  • TMB

    tumor mutation burden

  • TNBC

    triple-negative breast cancer

  • TNM

    tumor node metastasis staging

  • TROP2

    trophoblast cell-surface antigen 2

  • tSCLC

    transformed small cell lung cancer

  • TSST

    time to start of second subsequent therapy

  • TTD

    time to deterioration

  • TTD

    time to treatment discontinuation

  • TTDM

    time to death or distant metastases

  • TTP

    time to progression

  • TTR

    time to recurrence

  • TURBT

    transurethral resection of bladder tumor

  • UC

    urothelial cancer

  • uHCC

    unresectable hepatocellular carcinoma

  • Vp1

    segmental portal vein

  • Vp3

    first-order branch of the portal vein

  • Vp4

    main trunk of the portal vein or contralateral first-order branch

  • WHO

    World Health Organization

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