Opdivo (nivolumab) is a prescription drug approved to treat non-small cell lung cancer (NSCLC). Opdivo is available only as a brand-name medication. It’s not available in a generic version.
Opdivo comes as a liquid solution that’s given as an intravenous (IV) infusion by a healthcare professional. An IV infusion is an injection into your vein given over a period of time.
The active ingredient in Opdivo is nivolumab. Opdivo belongs to a group of immunotherapy drugs called programmed death receptor-1 (PD-1) inhibitors. Immunotherapy drugs work with your immune system to fight cancer.
Opdivo is also approved to treat other types of cancer. This article focuses on how Opdivo works to treat NSCLC.
Opdivo is approved to treat NSCLC, which is the most common type of lung cancer. NSCLC starts forming in certain lung cells and grows to affect other parts of the lung.
Specifically, doctors prescribe Opdivo for adults to treat:
- NSCLC that can be removed surgically: For this use, you receive Opdivo before surgery with platinum doublet chemotherapy (a combination of platinum-based chemotherapy and another chemotherapy).
- NSCLC without certain genetic changes that can be removed surgically: For this use, you receive Opdivo with platinum doublet chemotherapy before surgery. After surgery, you may receive Opdivo alone.
- Metastatic NSCLC expressing a certain protein called PD-L1 and without certain genetic changes: Your doctor will test you for PD-L1, which is expressed by metastatic NSCLC, before starting treatment. For this use, you receive Opdivo with ipilimumab (Yervoy) as first-line treatment. (“Metastatic” means the cancer has spread from its original location to other parts of the body. “First-line treatment” means the first treatment for the disease.)
- Metastatic or returning NSCLC without certain genetic changes: For this use, you receive Opdivo along with ipilimumab and 2 cycles of platinum doublet chemotherapy as first-line treatment.
- Metastatic and progressive (spreading) NSCLC despite receiving platinum-based chemotherapy: People with this NSCLC who have certain genetic changes should receive other cancer drugs for these changes before receiving Opdivo.
Note: The genetic changes for Opdivo’s uses refer to abnormalities or changes in the EGFR and ALK genes.
Opdivo is an immunotherapy drug. This is a treatment that works with your immune system to fight cancer.
Optivo’s mechanism of action (how it works) in treating NSCLC involves a specific binding site. (This is a region where things can attach, or bind.) In NSCLC, the binding site is called programmed death receptor-1 (PD-1). These PD-1 receptors exist on different immune cells throughout the body. When certain proteins bind to the PD-1 receptors, this action can stop the immune system from attacking cancer cells. In turn, the cancer cells grow and progress.
Opdivo works by binding to PD-1 receptors and blocking these other proteins from attaching. This then allows your immune system to attack the cancer cells, thereby helping to treat NSCLC.
Opdivo has been shown to be effective in treating certain types of NSCLC.
In a study, Opdivo was used with ipilimumab (Yervoy) in adults to treat returning or metastatic NSCLC without certain genetic changes. People in this study received either Opdivo with ipilimumab or a platinum-containing chemotherapy. Treatment was continued for 24 months unless the cancer progressed or serious side effects were reported before this time.
Primary results from the study focused on people with metastatic NSCLC that expresses a certain protein called PD-L1. (Here “expresses” means a process converting genes into functional proteins.) Specifically, these people expressed PD-L1 protein on at least 1% of cancer cells.
At the end of the study, Opdivo in combination with ipilimumab improved overall survival rates. This rate is the length of time people live while receiving this combination treatment. Using Opdivo with ipilimumab reduced hospitalization or death related to NSCLC compared with using only platinum-containing chemotherapy.
Opdivo is recommended by the National Comprehensive Cancer Network (NCCN). Specifically, it recommends Opdivo as a first-line treatment option for people with metastatic NSCLC in certain situations.
This section details how adults receive Opdivo to treat certain types of NSCLC.
What is the usual dosage for Opdivo for lung cancer?
The following table summarizes the typical Opdivo dosages for NSCLC treatment expressed in milligrams (mg):
| Type of NSCLC | Typical Opdivo dosage |
|---|---|
| NSCLC that can be removed surgically | Opdivo treatment before surgery only: • 360 mg every 3 weeks for 3 cycles, in combination with platinum doublet chemotherapy Opdivo treatment before and after surgery: • Before surgery: 360 mg every 3 weeks for up to 4 cycles, in combination with platinum doublet chemotherapy • After surgery: 480 mg every 4 weeks for up to 13 cycles |
| Metastatic NSCLC | Opdivo treatment by itself: • 240 mg every 2 weeks, or • 480 mg every 4 weeks Opdivo treatment along with ipilimumab (Yervoy): • 360 mg every 3 weeks Opdivo treatment along with ipilimumab and platinum doublet chemotherapy: • 360 mg every 3 weeks |
Note: Opdivo has other uses in addition to treating lung cancer. The dosage may be different for these other uses. To learn more, talk with your doctor.
How do you receive Opdivo?
Opdivo comes as a liquid solution that you receive by intravenous (IV) infusion from your healthcare team. An IV infusion is an injection into your vein given over a period of time. A typical Opdivo infusion takes about 30 minutes.
How often should I receive Opdivo?
The frequency of Opdivo infusions depends on several factors. These include the type of NSCLC you have and the Opdivo dosage your doctor prescribes. Typically, you receive them every 2 to 4 weeks.
Using Opdivo for lung cancer may cause side effects in some people. These side effects can be mild to serious. Side effects of Opdivo may differ depending on whether Opdivo is received alone or in combination with other medications.
This section presents some of the common side effects reported by people. They received Opdivo on its own or with ipilimumab (Yervoy), platinum doublet chemotherapy, or ipilimumab and platinum doublet chemotherapy. For information about other possible side effects of the drug, talk with your doctor.
You can also learn more from the Opdivo side effects article or from Opdivo’s prescribing information.
Opdivo’s mild side effects
Here are some common mild side effects reported in some people. They received Opdivo on its own or with ipilimumab (Yervoy), platinum doublet chemotherapy, or ipilimumab and platinum doublet chemotherapy. The side effects include:
- tiredness
- skin rash
- muscle pain, bone pain, and joint pain
- nausea
- lack of appetite
- constipation
In many cases, mild side effects from the drug can be temporary. Some side effects may be easy to manage. But if side effects last for a longer time, bother you, or become severe, talk with your doctor.
Opdivo’s serious side effects
Using Opdivo may lead to rare but serious side effects. Examples include:
- immune system reaction, due to your immune system attacking your healthy cells (and not only cancer cells)
- infusion reaction
- kidney problem, including kidney swelling
- serious skin reaction, including Stevens-Johnson syndrome
- liver problem, including hepatitis
- hormone problem, including changes in thyroid hormone levels
- lung problem, including pneumonia
Call your doctor right away if you have any serious side effects during Opdivo treatment. If the side effects seem life threatening or you think you’re having a medical emergency, call 911. Or call your local emergency number immediately.
Allergic reactionFor some people, Opdivo can cause an allergic reaction.
In general, symptoms of an allergic reaction can be mild or serious.
What might helpIf you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. They can also determine whether you should continue Opdivo treatment.
If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911. Or call your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
Your doctor can confirm whether you’ve had a serious allergic reaction to Opdivo. If you have, they may switch you to a different treatment.
Before you start Opdivo treatment, consider this important information. The drug may not be a safe option if you have certain medical conditions or other factors that affect your health.
If any of the following medical conditions or health factors apply to you, talk with your doctor before starting Opdivo.
- immune system problems, including the following:
- nervous system problems, including myasthenia gravis or Guillain-Barré syndrome
- received an organ transplant, including a cornea transplant
- received or plan to receive stem cell transplant that uses donor stem cells (allogeneic)
- history of radiation treatment to your chest, and previously received medications similar to Opdivo
- pregnancy or breastfeeding
- alcohol consumption
- past allergic reaction to the drug or any of its ingredients
Here are some answers to some frequently asked questions about Opdivo.
Is Opdivo chemotherapy or immunotherapy?
Opdivo is a type of immunotherapy. It works with your immune system to fight cancer. Although Opdivo is not chemotherapy, it is used with it in certain situations to treat NSCLC.
Talk with your doctor if you have questions about Opdivo and available immunotherapies for NSCLC.
How does Opdivo compare vs. Keytruda?
Both Opdivo and Keytruda are approved for treating NSCLC. Studies of Opdivo and Keytruda have shown that both these drugs are effective for this use.
Opdivo and Keytruda belong to the same drug class. So they can cause similar serious side effects, including infusion reaction and immune system problems.
But they have some differences, including their dosing schedules. Opdivo is typically infused every 2 to 4 weeks for NSCLC. Keytruda can be infused every 3 or 6 weeks, depending on its dose. Because of this, one of them may be a better choice for you, depending on your specific health factors.
If you’re considering treatment with Opdivo or Keytruda, talk with your doctor about your health history. Ask whether one drug or the other may be a better option for you.
The price of Opdivo depends on several factors. These can include your treatment plan, your insurance plan, and your location. The price also depends on the cost for an appointment to receive doses of Opdivo from a healthcare professional.
Your cost may also depend on whether you qualify for any cost-saving programs. The manufacturer (maker) of Opdivo offers a patient support program that can help you learn about your financial support options.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.