How it is administered

Nivolumab is administered as an intravenous (IV) infusion or as a subcutaneous injection (in combination with hyaluronidase).

• For IV use, it is given over 30 to 60 minutes, typically every 2 or 4 weeks, depending on the specific cancer and regimen.
• For subcutaneous use (as in OPDIVO QVANTIG), it is injected into the abdomen or thigh by a healthcare professional every 2 to 4 weeks.

The exact dose and schedule depend on the type of cancer being treated and whether it is used alone or in combination with other medicines.

How it works

Nivolumab is an immunotherapy medication known as a checkpoint inhibitor. It is a monoclonal antibody that targets the PD-1 receptor on T cells, a part of your immune system. Normally, the PD-1 pathway helps keep the immune system in check and prevents it from attacking normal cells. However, some cancer cells use this pathway to hide from the immune system.

Nivolumab blocks the PD-1 receptor, preventing cancer cells from turning off the immune response. This allows the immune system's T cells to recognize and attack cancer cells more effectively. By releasing these 'brakes' on the immune system, nivolumab helps your body fight cancer more efficiently. This mechanism is used in a variety of cancers, including some blood cancers like classical Hodgkin lymphoma.

Who Should take it

Nivolumab is approved for use in several types of cancer, including certain blood cancers. For blood cancers, it is specifically indicated for adults with classical Hodgkin lymphoma (cHL) that has relapsed or progressed after stem cell transplantation and brentuximab vedotin, or after three or more lines of systemic therapy including stem cell transplantation.

It is also used in other cancers such as melanoma, non-small cell lung cancer, renal cell carcinoma, urothelial carcinoma, and more. The decision to use nivolumab depends on the cancer type, stage, previous treatments, and overall health. For peripheral T-cell lymphoma, there is no specific FDA approval, but it may be considered in clinical trials or off-label in certain cases.

Who should not take it

Nivolumab should not be used in patients with a known severe hypersensitivity to the drug or any of its components. It is not recommended for use in combination with thalidomide analogues and dexamethasone in multiple myeloma outside of clinical trials, due to increased mortality seen in studies.

Patients with active autoimmune diseases, those requiring systemic immunosuppression, or with organ transplants should use caution, as nivolumab can worsen immune-related conditions. It is not recommended during pregnancy or breastfeeding, as it may harm the fetus or infant. Always discuss your full medical history with your healthcare provider before starting nivolumab.

Commonly used with

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

• Ipilimumab (another immune checkpoint inhibitor)
• Chemotherapy agents (like platinum-doublet chemotherapy)
• Targeted therapies (such as cabozantinib)

The combination depends on the type of cancer and the specific treatment plan. For blood cancers like classical Hodgkin lymphoma, it is usually used as a single agent after other treatments have failed.

Commonly tested with

Nivolumab has been tested in combination with:

• Ipilimumab (for enhanced immune response)
• Chemotherapy agents (for various solid tumors)
• Other immunotherapies and targeted therapies in clinical trials

For blood cancers, it has been studied with brentuximab vedotin and after stem cell transplantation. Clinical trials continue to explore new combinations and uses, including for T-cell lymphomas and other hematologic malignancies.