Opdivo represents a significant advancement in cancer treatment, particularly for lung cancer, by harnessing the body’s own immune system. This medication is a form of immunotherapy, a class of treatments that work differently from traditional chemotherapy or radiation. Instead of directly attacking cancer cells, Opdivo aims to empower the patient’s immune defenses to recognize and eliminate cancerous growths. Its introduction has expanded treatment options for various cancer types.
Understanding Opdivo
Opdivo, known generically as nivolumab, is a monoclonal antibody. This biologic medication targets specific substances in the body. For lung cancer, Opdivo works by interacting with the immune system to restore its ability to fight cancer cells effectively.
Opdivo is categorized as a programmed death receptor-1 (PD-1) inhibitor, falling under a broader group of drugs called immune checkpoint inhibitors. It is administered as an intravenous infusion. It activates the body’s natural defenses against the disease.
How Opdivo Fights Lung Cancer
Opdivo functions as a PD-1 checkpoint inhibitor, enabling the immune system to target cancer cells. Immune cells, specifically T cells, have a protein called PD-1 on their surface, which acts as a “brake” on the immune response. Cancer cells can exploit this pathway by expressing proteins like PD-L1, which bind to PD-1 on T cells, deactivating them and allowing the cancer to evade detection.
Opdivo works by binding to the PD-1 receptor on T cells. This binding prevents PD-L1 from attaching to PD-1, releasing the “brake” on the T cells. Once this inhibition is removed, T cells reactivate and can recognize and attack cancer cells. This process enhances the body’s natural anti-tumor activity.
Who Qualifies for Opdivo Treatment
Opdivo is approved for treating specific types and stages of lung cancer, primarily non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). For NSCLC, it may be used in adults with metastatic disease, especially if their tumors express PD-L1 (at least 1%) and do not have certain genetic changes like EGFR or ALK genomic tumor aberrations. In these cases, Opdivo might be used as a first-line treatment, sometimes in combination with ipilimumab or with platinum-doublet chemotherapy.
Opdivo is also indicated for metastatic NSCLC that has progressed after platinum-based chemotherapy. If the cancer has specific genetic changes, patients need to receive targeted therapies for those changes before Opdivo is considered. For small cell lung cancer, Opdivo has an accelerated approval for metastatic cases that have progressed after platinum-based chemotherapy and at least one other line of therapy.
Navigating Opdivo Treatment
Opdivo is administered intravenously. Each infusion takes about 30 minutes. The frequency of treatment varies, ranging from every two to four weeks, depending on the specific cancer and treatment plan.
Patients may experience common to serious immune-related side effects. Common side effects include fatigue, rash, itching, muscle and joint pain, diarrhea, nausea, cough, and decreased appetite. More serious immune-related side effects can occur when the activated immune system affects healthy organs, potentially leading to inflammation of the lungs (pneumonitis), colon (colitis), liver (hepatitis), kidneys (nephritis), or endocrine glands. Healthcare providers closely monitor patients for these side effects, and management often involves corticosteroids or hormone replacement therapies. In some instances, treatment may need to be delayed or permanently discontinued if severe side effects occur.