nivolumab

Nivolumab is a human monoclonal antibody that targets the programmed cell death protein 1 (PD-1) receptor on T cells. By blocking PD-1, it prevents inhibitory signaling from PD-L1 and PD-L2, helping to restore T-cell–mediated immune responses against cancer cells. It is developed by Bristol Myers Squibb and marketed under the brand name Opdivo, among others.

Nivolumab has been approved for treatment of a range of advanced or metastatic cancers. These include unresectable or metastatic melanoma; non-small cell lung cancer (NSCLC); renal cell carcinoma; squamous cell carcinoma of the head and neck; classical Hodgkin lymphoma; urothelial carcinoma; hepatocellular carcinoma; and gastric or gastroesophageal junction adenocarcinoma, among others and in various lines of therapy. The approvals have often been based on improvements in overall survival or progression-free survival in clinical trials.

Administration and dosing vary by indication and prior treatments. Nivolumab is given as an intravenous infusion, typically every two to four weeks, depending on the regimen. It may be used as monotherapy or in combination with other immunotherapies, such as ipilimumab (an anti-CTLA-4 antibody) for selected cancers. Combination therapy can improve response rates in some settings but may increase the risk of immune-related adverse events.

Safety and monitoring: nivolumab commonly causes fatigue, rash, pruritus, and diarrhea. Serious immune-related adverse events can affect the gut, liver, lungs, endocrine glands, and other organs, and may require corticosteroids or other immunosuppressants. Patients on nivolumab require regular monitoring of organ function and prompt management of toxicities, with treatment withheld or discontinued if needed.