# Tremelimumab

Source: https://onco.cc/drugs/tremelimumab/  
OnCo record `tremelimumab` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Tremelimumab is AstraZeneca's CTLA-4 antibody, given as a single priming dose with durvalumab and chemotherapy in lung and liver cancer.

## Summary

Tremelimumab is a human IgG2 antibody against CTLA-4, the checkpoint that restrains T-cell priming; a limited number of priming doses alongside a PD-L1 antibody keeps toxicity lower than continuous CTLA-4 blockade. It is used with durvalumab and platinum chemotherapy in first-line metastatic NSCLC without EGFR or ALK alterations, and with durvalumab in unresectable hepatocellular carcinoma. POSEIDON showed tremelimumab plus durvalumab plus chemotherapy improved overall survival versus chemotherapy (HR 0.77), with the largest benefit in STK11/KEAP1/KRAS-mutant and PD-L1-negative disease. Approved November 2022 (NSCLC) and October 2022 (HCC with durvalumab, HIMALAYA). Whether the CTLA-4 component justifies its extra immune toxicity remains debated. For a newcomer, it is the second checkpoint antibody in AstraZeneca's combinations, given briefly to kick-start the immune response.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-06
- Brand: Imjudo
- Modality: Monoclonal antibody (anti-CTLA-4)
- Mechanism: Human IgG2 anti-CTLA-4; limited priming doses reduce toxicity.
- Approvals: US 2022: Metastatic NSCLC without EGFR/ALK, with durvalumab and platinum chemotherapy; unresectable HCC with durvalumab

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Tremelimumab
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Tremelimumab

## Connected records

- cancers: [Advanced hepatocellular carcinoma (BCLC C)](https://onco.cc/cancers/hcc-advanced/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [Intermediate hepatocellular carcinoma (BCLC B)](https://onco.cc/cancers/hcc-intermediate/), [Limited-stage small-cell lung cancer](https://onco.cc/cancers/limited-stage-sclc/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [Microsatellite-unstable (MSI-high) gastric cancer](https://onco.cc/cancers/gastric-msi-high/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/)
- technologies: [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/)
- targets: [CTLA-4](https://onco.cc/targets/ctla4/)
- drugs: [Durvalumab](https://onco.cc/drugs/durvalumab/)
- companies: [AstraZeneca](https://onco.cc/companies/astrazeneca/)
- trials: [A Study of Durvalumab or Tremelimumab Monotherapy, or Durvalumab in Combination With Tremelimumab or Bevacizumab in Advanced Hepatocellular Carcinoma](https://onco.cc/trials/nct02519348/), [A Study to Investigate the Efficacy of Durvalumab Plus Tremelimumab in Combination With Chemotherapy Compared With Pembrolizumab in Combination With Chemotherapy in Metastatic NSCLC Patients With Non-squamous Histology Who Have Mutations and/or Co-mutations in STK11, KEAP1, or KRAS](https://onco.cc/trials/nct06008093/), [Cabozantinib Plus Durvalumab With or Without Tremelimumab in Patients With Gastroesophageal Cancer and Other Gastrointestinal Malignancies](https://onco.cc/trials/nct03539822/), [CASPIAN](https://onco.cc/trials/caspian/), [Combined Treatment of Durvalumab, Bevacizumab, Tremelimumab and Transarterial Chemoembolization (TACE) in Subjects With Hepatocellular Carcinoma or Biliary Tract Carcinoma](https://onco.cc/trials/nct03937830/), [Durvalumab (MEDI4736) and Tremelimumab and Radiation Therapy in Hepatocellular Carcinoma and Biliary Tract Cancer](https://onco.cc/trials/nct03482102/), [Durvalumab and Tremelimumab as First Line Treatment in Participants With Advanced Hepatocellular Carcinoma (HCC)](https://onco.cc/trials/nct05883644/), [Durvalumab and Tremelimumab for Pediatric Malignancies](https://onco.cc/trials/nct03837899/), [Durvalumab and Tremelimumab in Combination With Chemotherapy in HIV-infected Patients With Non-small Cell Lung Cancer](https://onco.cc/trials/nct04499053/), [Durvalumab and Tremelimumab in Combination With Propranolol and Chemotherapy for Treatment of Advanced Hepatopancreabiliary Tumors (BLOCKED)](https://onco.cc/trials/nct05451043/), [Durvalumab and Tremelimumab With Lenvatinib as First-line Treatment in Patients With Unresectable Hepatocellular Carcinoma](https://onco.cc/trials/nct07081633/), [Durvalumab Plus Tremelimumab as First-line Treatment in Chinese Patients With uHCC](https://onco.cc/trials/nct05557838/), [EMERALD-3](https://onco.cc/trials/emerald-3/), [HIMALAYA](https://onco.cc/trials/himalaya/), [Immunotherapy Combined With Y-90 SIRT Therapy in Advanced Stage Intrahepatic Biliary Tract Cancer (BTC)](https://onco.cc/trials/nct04238637/), [Lung-MAP (SWOG S1400 and S1900)](https://onco.cc/trials/lung-map/), [Personalized Escalation of Consolidation Treatment Following Chemoradiotherapy and Immunotherapy in Stage III NSCLC in Stage III NSCLC](https://onco.cc/trials/nct04585490/), [Phase III Open Label First Line Therapy Study of MEDI 4736 (Durvalumab) With or Without Tremelimumab Versus SOC in Non Small-Cell Lung Cancer (NSCLC)](https://onco.cc/trials/nct02453282/), [Phase III Study of Rilvegostomig in Combination With Bevacizumab With or Without Tremelimumab as First-line Treatment of Hepatocellular Carcinoma](https://onco.cc/trials/nct06921785/), [Randomized, Double-blind Study Comparing Tremelimumab to Placebo in Subjects With Unresectable Malignant Mesothelioma](https://onco.cc/trials/nct01843374/), [Single cEll pRofiling PErsistaNce To ImmuNothErapy](https://onco.cc/trials/nct06680739/), [Study of Durvalumab + Tremelimumab With Chemotherapy or Durvalumab With Chemotherapy or Chemotherapy Alone for Patients With Lung Cancer (POSEIDON).](https://onco.cc/trials/nct03164616/), [Study of Durvalumab Given With Chemotherapy, Durvalumab in Combination With Tremelimumab Given With Chemotherapy, or Chemotherapy in Patients With Unresectable Urothelial Cancer](https://onco.cc/trials/nct03682068/), [Study of Durvalumab With Tremelimumab Versus SoC as 1st Line Therapy in Metastatic Non Small-Cell Lung Cancer (NSCLC) (NEPTUNE)](https://onco.cc/trials/nct02542293/), [Study of MEDI4736 (Durvalumab) With or Without Tremelimumab Versus Standard of Care Chemotherapy in Urothelial Cancer](https://onco.cc/trials/nct02516241/), [Testing the Addition of an Individualized Vaccine to Durvalumab and Tremelimumab and Chemotherapy in Patients With Metastatic Triple Negative Breast Cancer](https://onco.cc/trials/nct03606967/), [Treatment Combination of Durvalumab, Tremelimumab and Enfortumab Vedotin or Durvalumab and Enfortumab Vedotin in Patients With Muscle Invasive Bladder Cancer Ineligible to Cisplatin or Who Refuse Cisplatin](https://onco.cc/trials/nct04960709/)
- pairings: [PD-1 blockade + chemotherapy in PD-L1-low NSCLC](https://onco.cc/pairings/pd1-plus-chemo-pdl1-low/)
- key papers: [ADRIATIC: durvalumab after chemoradiotherapy for limited-stage small-cell lung cancer](https://onco.cc/key-papers/paper-adriatic-nejm-2024/), [Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN)](https://onco.cc/key-papers/paper-paz-ares-caspian-durvalumab-es-sclc-lancet-2019/), [HIMALAYA: tremelimumab plus durvalumab in unresectable hepatocellular carcinoma](https://onco.cc/key-papers/paper-himalaya-nejm-evidence-2022/)
- pathways: [Hepatocellular carcinoma (KEGG map)](https://onco.cc/pathways/hepatocellular-carcinoma-signalling/)

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