Opdivo (nivolumab) is a prescription brand-name medication. It’s approved by the Food and Drug Administration (FDA) to treat certain types of metastatic non-small cell lung cancer (NSCLC) in adults.

NSCLC is the most common type of lung cancer. Metastatic means the cancer has spread from your lungs to other parts of your body.

For this use, Opdivo is typically prescribed in combination with the drug ipilimumab (Yervoy) and sometimes with chemotherapy made from platinum. Opdivo may also be used by itself.

Here are the basics on Opdivo:

  • Active ingredient: nivolumab
  • Drug class: programmed death receptor-1 (PD-1) inhibitor
  • Drug form: liquid solution for intravenous infusion
  • Available as biosimilar: no

Read on for more information on Opdivo and its use in treating lung cancer. Opdivo is also approved to treat several other types of cancer. You can refer to this article for a comprehensive look at this drug.

Opdivo is approved to treat metastatic* non-small cell lung cancer (NSCLC) in adults, in certain situations. If your doctor has prescribed Opdivo, you may be wondering how it works to treat this condition.

* Metastatic means the cancer has spread from your lungs to other parts of your body.

The way Opdivo works as immunotherapy

Opdivo is a type of immunotherapy. “Immunotherapy” means the drug works to help your immune system fight cancer.

Opdivo’s mechanism of action (how the drug works) involves an immune system protein called programmed death receptor-1 (PD-1). PD-1 receptors (docking stations) are found on immune cells throughout your body. If certain proteins attach to PD-1 receptors, this causes immune cells to stop producing proteins that attack cancer cells. This means the cancer is able to avoid attacks from your immune system.

Opdivo works by attaching to PD-1 receptors, so that other proteins are blocked from attaching to them. This allows your immune system to produce proteins that attack and kill cancer cells.

Clinical trials have found Opdivo to be effective for treating metastatic* non-small cell lung cancer (NSCLC) in adults.

One trial found that people who took Opdivo had longer survival compared with people who took docetaxel, a chemotherapy drug. “Survival” referred to the length of time people lived while receiving treatment.

Another trial found that people who took Opdivo had better success rates compared with people taking docetaxel. “Success rate” referred to how many people’s cancer responded to treatment with Opdivo.

Opdivo is recommended by the National Comprehensive Cancer Network as a treatment option for metastatic* NSCLC with confirmed PD-1 receptor presence on at least 1% of cancer cells.

* Metastatic means the cancer has spread from your lungs to other parts of your body.

Here are some frequently asked questions about using Opdivo to treat lung cancer.

Does Opdivo treat squamous cell lung cancer?

Yes, Opdivo has been shown to be effective for treating squamous cell lung cancer.

Squamous cells are flat cells that are found in the outer layer of your skin as well as lining parts of your body. This includes the airways in your lungs. One clinical trial of Opdivo involved adults with squamous non-small cell lung cancer (NSCLC). Researchers found that people with squamous NSCLC who took Opdivo had a lower risk of death compared with people who took the chemotherapy drug docetaxel.

If you have questions about Opdivo for squamous cell lung cancer treatment, talk with your doctor.

Is Opdivo approved to treat stage 4 lung cancer?

Yes, in certain situations. Stage 4 lung cancer is metastatic, which means the cancer has spread from your lungs to other parts of your body. And Opdivo is approved for use in adults with certain types of metastatic non-small cell lung cancer (NSCLC).

See the “Lung cancer explained” section below for more information about lung cancer and the types that Opdivo is used to treat.

How much Opdivo costs is based on several factors. These can include your prescribed treatment regimen, the insurance plan you have, the pharmacy you use, and your location. The price is also dependent upon the cost of the appointment to receive doses of Opdivo from your healthcare provider. For estimates of how much Opdivo costs, see GoodRx.com.

Opdivo is a brand-name biologic medication that’s not available as a generic or biosimilar. Biologic drugs are made from living cells, so it’s not possible to copy these drugs exactly. But a biosimilar drug is similar to the brand-name drug and is considered to be just as safe and effective. And, biosimilars tend to cost less than brand-name medications.

The use of Opdivo may cause side effects that are mild or serious. The lists below include some of the main side effects that have been reported with Opdivo use. For information on other potential side effects of the drug, talk with your doctor or pharmacist. You can also see our article on Opdivo or refer to the Opdivo medication guide.

Side effects in clinical trials of Opdivo varied depending on whether Opdivo was used by itself or with other medications. The side effects discussed below were seen in people taking Opdivo with ipilimumab (Yervoy). For treating metastatic* non-small cell lung cancer (NSCLC), Opdivo is typically taken in combination with the drug ipilimumab, and sometimes with chemotherapy made from platinum.

Note: After the Food and Drug Administration (FDA) approves a medication, it tracks side effects of the drug. If you develop a side effect while taking Opdivo and would like to inform the FDA, visit MedWatch.

* Metastatic means the cancer has spread from your lungs to other parts of your body.

Mild side effects

When used in combination with ipilimumab (Yervoy) to treat adults with metastatic NSCLC, common mild side effects of Opdivo can include:

These side effects of Opdivo may be temporary, lasting a few days or weeks. But if they last longer, or if they bother you or become severe, it’s important to talk with your doctor or pharmacist.

Serious side effects

Although not common, Opdivo may cause serious side effects, including:

Call your doctor right away if you develop serious side effects while using Opdivo. If the side effects seem life threatening or if you think you’re having a medical emergency, call 911 or your local emergency number immediately.

* An allergic reaction is possible after using Opdivo. However, it’s not clear how many people reported this side effect in clinical studies.

With cancer, abnormal cells in your body divide and spread quickly. Lung cancer begins in the lung, and there are two main types:

NSCLC is the most common type of lung cancer. It grows more slowly than SCLC.

This article focuses on NSCLC, since Opdivo is approved to treat metastatic NSCLC in certain situations. “Metastatic” means the cancer has spread from your lungs to other parts of your body.

Symptoms of non-small cell lung cancer

NSCLC doesn’t usually cause symptoms early on. As the cancer grows, it may begin to cause symptoms such as:

  • breathing problems, such as shortness of breath
  • chest pain
  • coughing up blood
  • fatigue (lack of energy)
  • persistent cough
  • weakness

Metastatic NSCLC can cause symptoms such as:

  • trouble breathing
  • pain in areas where the cancer has spread, such as in your bones, head, neck, or abdomen (belly)
  • problems speaking
  • seizures (changes in electrical activity in your brain)
  • worsened fatigue and weakness

Who can use Opdivo for lung cancer?

Opdivo can be used in adults to treat:

  • Metastatic NSCLC that doesn’t have certain genetic changes,* and expresses a certain amount of a protein called PD-1. Your doctor will order a test to determine if your cancer meets this PD-1 requirement. For this purpose, Opdivo is used in combination with the drug ipilimumab (Yervoy).
  • Metastatic or recurrent† NSCLC that doesn’t have certain genetic changes.* For this purpose, Opdivo is used in combination with ipilimumab and with two cycles of chemotherapy made from platinum.
  • Metastatic NSCLC that has spread or progressed despite treatment with chemotherapy made from platinum. If your cancer has certain genetic changes,* you need to receive certain cancer drugs that are specific for these gene changes before using Opdivo.

* These genetic changes refer to abnormalities in parts of genes called EGFR and ALK.
† Recurrent means that the cancer has returned after responding to prior treatment.

Opdivo is approved to treat certain types of metastatic* non-small cell lung cancer (NSCLC) in adults. Below are details on using Opdivo to treat this condition.

* Metastatic means the cancer has spread from your lungs to other parts of your body.

Dosage

The typical dosage of Opdivo for treating NSCLC when used alone is either:

  • 240 milligrams (mg) every 2 weeks, or
  • 480 mg every 4 weeks

When taken with the drug ipilimumab (Yervoy), the typical dosage of Opdivo is 3 (mg) per kilogram (kg) of body weight, every 2 weeks.

When taken with ipilimumab and chemotherapy made from platinum, the recommended Opdivo dosage is 360 mg, every 3 weeks.

Note: In addition to treating lung cancer, Opdivo has other uses. Keep in mind that the drug’s dosage may differ with these other uses. To learn more, talk with your doctor.

How to use

Opdivo comes as a liquid solution. It’s given by a healthcare provider as an intravenous infusion. Opdivo infusions typically last about 30 minutes.

How often to use

How often you’ll get Opdivo infusions depends on the dosage your doctor has prescribed for you. For treating NSCLC, you’ll get Opdivo infusions every 2, 3, or 4 weeks.

Before you use Opdivo, there’s some important information to keep in mind. The drug may not be a safe option if you have certain medical conditions or other factors that affect your health. Some of these are mentioned below.

If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before using Opdivo:

Now that you’ve learned about Opdivo for lung cancer, you may still have some questions. Talk with your doctor or pharmacist, who can advise you on whether Opdivo might be right for you.

Here are some other helpful references:

  • More details. For details about other aspects of Opdivo, refer to this article.
  • Drug comparison. To find out how Opdivo compares with Keytruda, read this article.
  • Information on lung cancer. For more information on lung cancer, see our list of lung cancer articles.

Disclaimer: Medical News Today 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 other 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.