Editor-In-Chief of Hematology and Oncology - Beaula Koduri, MD
Beaula Koduri, MD is a leading board certified hematology and oncology physician with over 16 years of practice experience in treating patients for a variety of conditions in the field of hematology and oncology. Dr Koduri is the founder and medical director of Hematology Oncology Consultants. Dr Koduri is board certified by the American Board of Internal Medicine (ABIM) in many specialties including internal medicine, hematology, and oncology. As a passionate, and detail oriented physician, Dr. Koduri is known for her compassionate care and is very knowledgeable on the latest treatments available in the ever changing field of hematology and oncology.
Information about Nivolumab
Liver safety of Nivolumab
Mechanism of action of Nivolumab
Nivolumab (nye vol' ue mab) is a human recombinant monoclonal immunoglobulin G4 antibody to the programmed cell death receptor-1 (PD-1) which has distinctive immunomodulatory activity and is used in cancer immunotherapy.
What is PD-1?
- Programmed cell death receptor 1 or PD-1 is an important check point molecule that modulates and down regulates T cell responses.
- Inhibition of PD-1 receptors on the surface of activated T cells prevents their binding to the costimulatory factor B7 and consequently allows for a continued activation and proliferation of T cells.
- The subsequent enhancement of cytotoxic reactivity may play a beneficial role in cancer immunotherapy by breaking immunological tolerance to cancer cell associated antigens.
- In several large multicenter studies, nivolumab therapy resulted in a prolongation of survival in patients with advanced, metastatic or unresectable malignant melanoma, and a proportion of patients had a long term remission.
FDA approval information for Nivolumab
Nivolumab was approved for use in advanced melanoma in the United States in 2015 and is under active investigation in several other forms of cancer, including renal, breast and colon cancer.
- Nivolumab is available in liquid solution in 40 and 100 mg vials (10 mg/mL) under the brand name Opdivo.
- The typical regimen is 3 mg/kg as an intravenous infusion every 2 weeks.
Combination with Ipilimumab
- In 2015, the combination of nivolumab with ipilimumab, a monoclonal antibody to CTLA-4, another check point molecule, was approved as combination immunotherapy for malignant melanoma.
Side effects of Nivolumab
- Side effects of nivolumab are common and can be severe.
- As many as half of treated patients develop immune related side effects as a result of immune enhancement including enterocolitis, dermatitis, endocrinopathy, pneumonitis, neuropathy, nephritis and hepatitis.
Treatment of immune reactions
- Most of these reactions respond to immunosuppressive therapy, but some have resulted in fatalities and some have required long term therapy. * Early recognition and prompt management of these side effects is an integral component of proper use of nivolumab and other check point inhibitors such as ipilimumab and pembrolizumab.
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Reviews for Nivolumab
Learn more about Nivolumab
Latest research (Pubmed)