Cancer treatment has undergone significant advancements, moving beyond traditional approaches to embrace innovative therapies. These newer methods leverage the body’s own defense mechanisms to combat disease. Immunotherapy represents a modern approach in this evolving landscape, offering a distinct strategy compared to conventional treatments. This innovative field continues to expand, providing new possibilities for patients.
What Opdivo Is
Opdivo (nivolumab) is an immunotherapy drug, an immune checkpoint inhibitor. It helps the immune system recognize and target cancer cells. Unlike chemotherapy, Opdivo enhances the body’s defenses against cancer.
Cancers Treated by Opdivo
Opdivo treats various cancers, often when other therapies fail or in combination with other drugs. It is approved for melanoma, non-small cell lung cancer (NSCLC), kidney cancer, and classical Hodgkin lymphoma. Other uses include head and neck squamous cell carcinoma, urothelial carcinoma, colorectal cancer, hepatocellular carcinoma, esophageal squamous cell carcinoma, and certain gastric, gastroesophageal junction, and esophageal adenocarcinomas. Research continues to expand Opdivo’s applications.
How Opdivo Works
Opdivo targets the PD-1/PD-L1 immune checkpoint pathway. Cancer cells evade detection by expressing PD-L1, which binds to PD-1 on T-cells, sending a “stop” signal. Opdivo blocks PD-1, “releasing the brakes” on T-cells. This reactivates T-cells to recognize and attack cancer cells, allowing the immune system to fight cancer.
Navigating Opdivo Treatment
Opdivo is given intravenously, typically every two or four weeks. Treatment duration varies. Common side effects include fatigue, rash, diarrhea, nausea, and muscle pain. Immune-related adverse events (irAEs) are possible, where the immune system attacks healthy tissues. Patients must report new symptoms for early management.
What Opdivo Is
Opdivo, known by its generic name nivolumab, is an immunotherapy drug, specifically an immune checkpoint inhibitor. It assists the body’s natural immune system in recognizing and targeting cancer cells. This medication is distinct from chemotherapy, which directly attacks rapidly dividing cells, including healthy ones. Opdivo functions by enhancing the immune system’s ability to identify threats, empowering the body’s own defenses. This targeted approach represents a significant shift in cancer therapy.
Cancers Treated by Opdivo
Opdivo treats various cancers, often after other treatments fail or in combination with other drugs. It is used for unresectable or metastatic melanoma, a severe skin cancer, alone or with other immunotherapies. It also serves as adjuvant treatment for certain melanoma stages after surgical removal to prevent recurrence.
For non-small cell lung cancer (NSCLC), Opdivo is approved for metastatic cases progressing after platinum-based chemotherapy. It can also be a first-line treatment for metastatic NSCLC with other immunotherapies or chemotherapy, especially in PD-L1 expressing tumors. Opdivo is also indicated as neoadjuvant treatment with platinum-doublet chemotherapy for resectable NSCLC, followed by single-agent adjuvant treatment after surgery for certain patients.
For advanced renal cell carcinoma (RCC), Opdivo is used after prior anti-angiogenic therapy or as first-line treatment with another immunotherapy or cabozantinib. For classical Hodgkin lymphoma (cHL), Opdivo is approved for patients whose disease relapsed or progressed after specific prior therapies, including autologous hematopoietic stem cell transplantation and brentuximab vedotin, or after three or more lines of systemic therapy.
Opdivo treats recurrent or metastatic head and neck squamous cell carcinoma (SCCHN) that progressed on or after platinum-based therapy. For urothelial carcinoma, a bladder cancer, Opdivo is used for locally advanced or metastatic cases progressing during or after platinum-containing chemotherapy. It is also approved with cisplatin and gemcitabine as first-line treatment for unresectable or metastatic urothelial carcinoma and as adjuvant treatment for patients at high recurrence risk after radical resection.
For microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) colorectal cancer, Opdivo is an approved option, often with another immunotherapy, especially after progression on specific prior chemotherapy. Hepatocellular carcinoma, the most common liver cancer, can be treated with Opdivo in combination with another immunotherapy for first-line treatment or in patients previously treated with sorafenib.
Opdivo is also approved for advanced or metastatic esophageal squamous cell carcinoma (ESCC) after prior fluoropyrimidine- and platinum-based chemotherapy. It can be a first-line treatment for ESCC with chemotherapy or another immunotherapy. Opdivo, with fluoropyrimidine- and platinum-containing chemotherapy, is indicated for advanced or metastatic gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma, particularly when tumors express PD-L1. New indications are continuously explored.
How Opdivo Works
Opdivo functions by targeting the PD-1/PD-L1 immune checkpoint. Cancer cells often evade detection and destruction by the immune system. One common strategy involves expressing a protein called PD-L1 on their surface. This PD-L1 protein can bind to a receptor called PD-1, found on the surface of immune cells, particularly T-cells.
When PD-L1 on a cancer cell binds to PD-1 on a T-cell, it sends a “stop” signal. This signal prevents the T-cell from recognizing and attacking the cancer cell, allowing the tumor to grow unchecked. Opdivo, as an anti-PD-1 antibody, works by blocking the PD-1 receptor on the T-cells.
This blockade “releases the brakes” on the immune system’s T-cells. Once the inhibitory signal is disrupted, T-cells are reactivated. They can then recognize the cancer cells as foreign and mount an immune response. This mechanism allows the body’s own immune defenses to fight the cancer.
Navigating Opdivo Treatment
Receiving Opdivo involves a specific administration process and requires careful monitoring throughout the course of therapy. Opdivo is administered intravenously, meaning it is given directly into a vein through an infusion. The infusion typically takes about 30 to 60 minutes, and the frequency of treatment can vary, often every two or four weeks, depending on the specific cancer type and treatment plan. The duration of Opdivo treatment also varies greatly among individuals and depends on factors such as treatment response and tolerability, sometimes continuing for up to two years or until disease progression or unacceptable toxicity. Common side effects that patients might experience include fatigue, rash, diarrhea, nausea, and musculoskeletal pain. Other common side effects can include decreased appetite, cough, shortness of breath, and headache.
A particularly important aspect of Opdivo treatment involves the potential for immune-related adverse events (irAEs). These occur when the activated immune system, now more potent, mistakenly attacks healthy tissues and organs in the body. IrAEs can affect almost any organ, including the lungs (pneumonitis), colon (colitis), liver (hepatitis), kidneys (nephritis), and endocrine glands, leading to conditions like thyroid dysfunction or adrenal insufficiency.
Patients receiving Opdivo must promptly report any new or worsening symptoms to their healthcare team. Early detection and management of irAEs are crucial, as they may require temporary pauses in treatment or the use of corticosteroids to suppress the overactive immune response. Regular monitoring through blood tests and physical examinations helps the healthcare team track a patient’s response to therapy and manage any potential side effects.