Nivolumab

Products

Nivolumab was approved in the United States in 2014 and in the in many countries and the EU in 2015 as a concentrate for the preparation of an infusion solution (Opdivo).

Structure and properties

Nivolumab is a human monoclonal antibody. It is an IgG4κ-immunoglobulin with a molecular mass of 146 kDa. Nivolumab is produced by biotechnological methods.

Effects

Nivolumab (ATC L01XC17) has immunostimulatory and indirect antitumor properties. Unlike traditional cytostatic agents, the antibody itself is not cytotoxic. Nivolumab binds to the PD-1 receptor (programmed death receptor 1) on T cells and other immune cells, preventing interaction with the natural ligands PD-L1 and PD-L2 (programmed death ligand 1/2, Figure). The PD-1 receptor mediates immunosuppression. Some tumors express the ligands on the cell surface and thus protect themselves from the body’s own defenses. By binding to PD-1, nivolumab stimulates T-cell activation and proliferation, allowing cancer cells to be destroyed. Nivolumab has a long half-life of approximately 26 days.

Indications

Nivolumab is approved for the treatment of several cancers. These include:

  • Non-small cell lung cancer.
  • Melanoma
  • Renal cell carcinoma
  • Classical Hodgkin’s lymphoma
  • Squamous cell carcinoma of the head and neck region
  • Colorectal carcinoma
  • Urothelial carcinoma
  • Adenocarcinoma of the stomach or gastroesophageal junction.

Dosage

According to the professional information. The drug is administered as an intravenous infusion.

Contraindications

  • Hypersensitivity
  • Pregnancy

Full precautions can be found in the drug label.

Interactions

Immunosuppressants may attenuate the effects of nivolumab. Nivolumab does not interact with CYP450 isozymes.

Adverse effects

The most common potential adverse effects include fatigue, rash, pruritus, diarrhea, and nausea.