Name of the Procedure:

Injection, Durvalumab, 10 mg
Common names: Durvalumab injection, anti-PD-L1 therapy
Technical/medical terms: Durvalumab (Imfinzi), immune checkpoint inhibitor

Summary

Durvalumab is an injectable medication used as an immunotherapy for certain types of cancers. It helps the body's immune system target and destroy cancer cells more effectively.

Purpose

Medical Conditions Addressed:

• Non-small cell lung cancer (NSCLC)
• Urothelial carcinoma (bladder cancer)

Goals:

• Shrink tumors
• Slow the progression of cancer
• Improve survival rates

Indications

Symptoms/Conditions:

• Patients with locally advanced or metastatic NSCLC after chemotherapy
• Patients with advanced urothelial carcinoma who have not responded to platinum-based chemotherapy

Patient Criteria:

• Confirmed diagnosis of eligible cancer type
• Adequate organ function
• No autoimmune disease or infections that could worsen with immunotherapy

Preparation

Pre-procedure Instructions:

• No specific fasting required
• Avoid certain medications that may affect immune system function
• Blood tests to assess liver, kidney function, and overall health

Pre-assessments:

• Complete physical examination
• Imaging tests (CT, MRI) to determine cancer status

Procedure Description

1. Pre-visit: Review of medical history and baseline blood tests.
2. Day of Injection:
   • Administered via intravenous (IV) infusion in the arm.
   • The infusion usually takes about 1 hour.
3. Monitoring: Vital signs monitored before, during, and after infusion.
4. Post-infusion: Observation for any adverse reactions.

Tools & Equipment:

• IV catheter and infusion pump
• Monitoring equipment (blood pressure cuff, thermometer)

Anesthesia/Sedation: Not typically required as this is a relatively non-invasive procedure.

Duration

The infusion process takes approximately 1 hour per session.

Setting

Usually performed in an outpatient clinic, hospital oncology unit, or specialized infusion center.

Personnel

• Oncologist or specialized nurse to administer and monitor the infusion
• Support staff may include medical assistants and pharmacists

Risks and Complications

Common Risks:

• Fatigue
• Nausea
• Decreased appetite

Rare Risks:

• Severe immune-mediated reactions (e.g., pneumonitis, colitis, hepatitis)
• Infusion-related reactions (e.g., chills, fever)

Management:

• Pre-medication with antihistamines or corticosteroids for severe reactions
• Symptom-specific treatments (e.g., antibiotics for infections)

Benefits

Expected Benefits:

• Tumor shrinkage
• Slow disease progression
• Extension of survival and potential improvement in quality of life

Onset of Benefits: Variable; some patients may notice improvements within weeks, while others may take longer.

Recovery

Post-procedure Care:

• Regular follow-up visits with the oncologist
• Blood tests to monitor health status and treatment effectiveness

Recovery Time: Generally rapid; most patients can resume normal activities shortly after each infusion session.

Restrictions:

• Avoid live vaccines
• Monitor for signs of infection or adverse reactions

Alternatives

Other Treatment Options:

• Traditional chemotherapy
• Targeted therapies
• Radiation therapy

Pros and Cons:

• Chemotherapy: More established but often more side effects
• Targeted Therapy: Specific to genetic mutations, fewer side effects but not suitable for all patients
• Radiation Therapy: Localized control, but not effective for widespread disease

Patient Experience

During Procedure:

• Minimal discomfort; patient remains seated or lying down.
• Possible slight pinch or burning sensation at the infusion site.

After Procedure:

• Potential mild side effects managed with medication.
• Regular activities can typically be resumed immediately but monitor for delayed reactions.
• Pain management involves over-the-counter medications if needed, and comfort measures such as rest and hydration.