In non-small cell lung cancer (NSCLC), immunotherapy is one of today's most 
important and ground-breaking systemic treatments, mainly represented by 
antibodies against cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and 
programmed death protein 1 or ligand 1 (PD-1/PD-L1). Durvalumab (MEDI4736) is a 
high-affinity human IgG1 monoclonal antibody that binds to PD-1 and CD80, 
blocking PD-L1, but not PD-L2. Areas covered: In advanced NSCLC patients, 
durvalumab has demonstrated activity and acceptable tolerability, particularly 
with ≥25% PD-L1 tumor expression in the EGFR and ALK wild-type population. 
However, preliminary data have shown lower efficacy in EGFR mutant and 
ALK-positive patients. The results from the recent PACIFIC study in locally 
advanced patients have placed durvalumab as standard of care in consolidation 
after chemoradiation, leading to Food and Drug Administration (FDA) approval. 
Expert commentary: Early data suggest promising activity for durvalumab with the 
CTLA-4 inhibitor tremelimumab, regardless of PD-L1 expression, and potentially 
in combination with other drugs such as platinum-doublet chemotherapy. However, 
treatment-related toxicity associated with the combinations is an important 
aspect of the benefit-risk evaluation in the decision-making process. Results of 
ongoing phase III trials will provide illuminating data to confirm the place of 
durvalumab in the management of NSCLC patients.