Doctors may recommend nivolumab (Opdivo) adjuvant for some people with bladder cancer. This includes those with a high risk of recurrence following bladder surgery and people who have received platinum chemotherapy but require further treatment.

Opdivo is an immunotherapy medication that helps boost a person’s immune system to treat cancer. Some research suggests that it may extend a person’s life by 9 months.

Due to Opdivo’s action, side effects are frequently autoimmune, where the body attacks its own cells. Some side effects are manageable, while others are life threatening.

The drug may also be called nivolumab.

Keep reading to learn more about Opdivo adjuvant for bladder cancer, including how it works, its side effects, and its effectiveness.

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Adjuvant therapy for cancer is an additional treatment a person receives following primary treatment to reduce the risk of cancer recurrence.

Doctors use Opdivo adjuvant therapy for urothelial carcinoma, the most common type of bladder cancer. This cancer affects the urothelial cells, which line the inside of the bladder and other parts of the urinary tract.

Additionally, Opdivo is a treatment for other types of cancer either alone or in combination with other therapies. Such cancers include:

The drug comes in a liquid form, and healthcare professionals typically administer it as an intravenous (IV) infusion, which takes approximately 30 minutes. For bladder cancer, people can expect Opdivo every 2 or 4 weeks.

Learn more about Opdivo here.

In bladder cancer, malignant cells form in bladder tissues. Signs and symptoms include:

Standard treatments for bladder cancer may involve:

  • surgery to remove the tumor
  • chemotherapy to kill fast-growing cancer cells
  • radiation therapy
  • targeted therapy — medications that target proteins that determine how cancer cells grow
  • immunotherapy, or biological therapy — the use of substances in either the body or a laboratory makes that improve someone’s natural defense against a condition

A person’s outlook depends on an array of factors, such as the:

  • stage of cancer
  • type of bladder cancer
  • size and number of tumors

Learn more about bladder cancer.

Opdivo is an immunotherapy drug that falls in a class called PD-1 inhibitors.

PD-1 is a protein on the surface of T cells that helps keep the immune system in check. PD-L1 is another protein that some types of cancer cells have.

When PD-1 binds to PD-L1, it prevents T cells from killing cancer cells in the body. This allows the cancer to keep growing.

Inhibitors, such as Opdivo, stop PD-1 and PD-L1 from binding together, which permits the body’s T cells to kill cancer cells.

Doctors might recommend Opdivo adjuvant therapy for people who:

  • have undergone surgery for bladder cancer
  • have a high risk of cancer recurrence
  • had previously received platinum chemotherapy to treat the cancer, but it was ineffective

Radical surgery is the standard treatment for bladder cancer that has spread to the underlying bladder muscle. However, a 2021 clinical trial notes the cancer recurs in more than 50% of people.

Researchers in the trial evaluated the value of the Opdivo drug on 709 people who had undergone surgery for bladder cancer. It compared the effects of the medication on approximately half of the participants and the effects of a placebo on the remaining half.

The analysis indicated that disease-free survival was significantly longer in individuals who took Opdivo. The median survival time — where a person was free of cancer recurrence outside the urinary tract — was 22.9 months with Opdivo. This compares with 13.7 months for those taking a placebo.

The Food and Drug Administration (FDA) based its approval of Opdivo on a clinical trial involving 270 participants with advanced or metastatic bladder cancer that had not responded well to platinum-based chemotherapy. Metastasis denotes cancer that has spread to another part of the body from the original tumor.

Of all the participants, researchers measured the drug’s activity in 265 people. A partial response denotes a decrease in the tumor size, and a complete response denotes the disappearance of the tumor.

Results showed that:

  • the tumor shrank measurably in 52 participants
  • among the 52 participants, 46 had a partial response, and 6 had a complete response
  • 3 people died following treatment

Some side effects are temporary and manageable, while others can be life threatening. The side effects people experience are frequently due to an autoimmune response, which can affect any organ system in the body.

Most commonly, these can include:

Opdivo may also affect glandular function and induce conditions that require a person to take hormones permanently. These are less common and may include:

  • Diabetes: The inability to produce or respond normally to insulin, the hormone that regulates blood sugar.
  • Hypothyroidism: The production of low amounts of thyroid hormones
  • Adrenal insufficiency: The production of low amounts of certain hormones from the adrenal glands, such as the stress hormone cortisol.
  • Hypopituitarism: The production of low amounts of one or more pituitary gland hormones.

Other less common or rare side effects include inflammation that affects the:

Opdivo adjuvant for bladder cancer is an additional therapy that doctors sometimes recommend after primary treatment, such as surgery or chemotherapy. The medication boosts the ability of a person’s own immune system to control cancer.

Evidence suggests that it may extend the life of a person with the most common type of bladder cancer by 9 months.

The most common side effects are an itchy rash, diarrhea, and colitis, but it can also cause serious and life threatening side effects.