Durvalumab (Imfinzi)

Canada’s Drug Agency (CDA-AMC) recommends that Imfinzi in combination with carboplatin and paclitaxel be reimbursed by public drug plans for the treatment of primary advanced or recurrent mismatch repair deficient (dMMR) endometrial cancer in patients who are candidates for systemic therapy, if certain conditions are met. Imfinzi in combination with carboplatin and paclitaxel should only be covered to treat adult patients with primary advanced or recurrent stage III or IV endometrial cancer whose disease has returned after initial treatment and who have not previously received systemic anticancer therapy for advanced disease or have not received prior adjuvant systemic anticancer therapy at least 6 months from the date the last dose was administered to the date of subsequent relapse. Eligible patients should have confirmed dMMR tumour status before starting treatment with Imfinzi and have a good performance status. Imfinzi should only be reimbursed in combination with carboplatin and paclitaxel if it is prescribed by clinicians with expertise in advanced uterine cancer, and treatment should be supervised and delivered in institutions with expertise in systemic therapy delivery. The total cost of durvalumab plus carboplatin and paclitaxel should be negotiated so that it does not exceed the total drug program cost associated with dostarlimab plus carboplatin and paclitaxel.