Common brand names

• Opdivo

How it is administered

Nivolumab is administered as an intravenous (IV) infusion, usually over 30 to 60 minutes, depending on the specific regimen and indication. It is available in single-dose vials for IV use. The typical dosing schedule is every 2 or 4 weeks, but the dose and frequency may vary based on the type of cancer and whether it is used alone or in combination with other medicines. For some indications, it can also be given as a subcutaneous injection (under the skin) in the abdomen or thigh, especially in the form of the OPDIVO QVANTIG formulation (nivolumab and hyaluronidase). All administrations are performed by healthcare professionals in a clinic or hospital setting.

How it works

Nivolumab is an immunotherapy medicine known as a checkpoint inhibitor. It is a monoclonal antibody that targets the PD-1 (programmed death-1) receptor on T cells, which are a type of white blood cell involved in the immune response. Normally, the PD-1 pathway helps keep the immune system from attacking normal cells in the body. However, some cancer cells use this pathway to hide from the immune system. By blocking PD-1, nivolumab releases the brakes on the immune system, allowing it to recognize and attack cancer cells more effectively.

In blood cancers like classical Hodgkin lymphoma (cHL), nivolumab helps the immune system find and destroy cancerous cells that may have previously been able to evade detection. This can help slow the growth of the cancer, shrink tumors, or even lead to remission in some patients. The immune response can continue to work against cancer cells even after treatment has stopped, but the effects can vary from person to person.

Who should take it

Nivolumab is approved for use in adults with classical Hodgkin lymphoma (cHL) that has relapsed or progressed after an autologous stem cell transplant and brentuximab vedotin, or after three or more lines of systemic therapy that includes autologous stem cell transplant. It is also used in other blood cancers and solid tumors, depending on the specific diagnosis and previous treatments.

For patients with blood cancers, nivolumab may be considered when standard therapies have not worked or the cancer has returned. It is often used in combination with other treatments, such as ipilimumab or chemotherapy, depending on the cancer type and stage. Your healthcare team will determine if nivolumab is appropriate based on your cancer type, treatment history, and overall health.

Who should not take it

Nivolumab should not be used in patients who have had a severe allergic reaction to nivolumab or any of its ingredients. It is also not recommended for patients with certain autoimmune diseases or those who are taking immunosuppressive medications, unless the potential benefits outweigh the risks.

Patients who are pregnant or breastfeeding should avoid nivolumab, as it can harm an unborn baby or nursing infant. Nivolumab can also cause serious immune-mediated side effects, so patients with a history of severe immune-related conditions should discuss the risks with their doctor. It is important to inform your healthcare provider about all your medical conditions and medications before starting treatment.

Commonly used with

Nivolumab is often used in combination with other cancer treatments, such as:

• Ipilimumab (another immunotherapy medicine)
• Chemotherapy (such as platinum-based regimens)
• Targeted therapies (like cabozantinib in kidney cancer)

The combination depends on the type of cancer being treated and the patient's previous treatments. For blood cancers like classical Hodgkin lymphoma, it may be used alone or after other therapies have failed.

Commonly tested with

Nivolumab has been tested in combination with:

• Ipilimumab (for various cancers, including blood cancers)
• Chemotherapy agents (for solid tumors and some blood cancers)
• Other immunotherapies and targeted therapies in clinical trials

These combinations are studied to determine if they improve outcomes compared to single-agent therapy. Your healthcare team will choose the best combination based on the latest research and your individual situation.