Opdivo (Nivolumab) vs Afinitor (everolimus)
Opdivo (Nivolumab) vs Afinitor (everolimus)
Opdivo (nivolumab) is an immune checkpoint inhibitor that works by enhancing the body's immune response against cancer cells, and it is commonly used in the treatment of various types of cancers, including melanoma, lung cancer, and kidney cancer. Afinitor (everolimus), on the other hand, is an mTOR inhibitor that targets a specific cellular pathway to slow the growth of cancer cells, and it is often prescribed for advanced kidney cancer, certain breast cancers, and neuroendocrine tumors. When deciding between the two medications, it is crucial to consider the specific type of cancer being treated, the stage of the disease, the patient's overall health, and previous treatments, as these factors can influence the effectiveness and suitability of each drug.
Difference between Opdivo and Afinitor
| Metric | Opdivo (Nivolumab) | Afinitor (everolimus) |
|---|---|---|
| Generic name | Nivolumab | Everolimus |
| Indications | Various types of cancer, including melanoma, lung cancer, kidney cancer, bladder cancer, head and neck cancer, and more. | Advanced hormone receptor-positive, HER2-negative breast cancer, advanced neuroendocrine tumors, renal cell carcinoma, subependymal giant cell astrocytoma (SEGA), and renal angiomyolipoma associated with tuberous sclerosis complex. |
| Mechanism of action | Programmed death receptor-1 (PD-1) blocking antibody, which helps the immune system attack cancer cells. | mTOR inhibitor, which helps to stop cancer cells from growing and multiplying, and can reduce blood supply to the tumor. |
| Brand names | Opdivo | Afinitor, Afinitor Disperz |
| Administrative route | Intravenous infusion | Oral |
| Side effects | Fatigue, rash, musculoskeletal pain, pruritus, diarrhea, nausea, weakness, cough, dyspnea, constipation, decreased appetite, back pain, arthralgia, upper respiratory tract infection, pyrexia, headache, abdominal pain, and vomiting. | Stomatitis, infections, rash, fatigue, diarrhea, edema, abdominal pain, nausea, fever, asthenia, cough, headache, decreased appetite, dyspnea, vomiting, and decreased weight. |
| Contraindications | Patients with hypersensitivity to nivolumab or any of its excipients. | Patients with hypersensitivity to everolimus or other rapamycin derivatives or any of its excipients. |
| Drug class | Monoclonal antibody, Immune checkpoint inhibitor | mTOR inhibitor, Kinase inhibitor |
| Manufacturer | Bristol-Myers Squibb | Novartis Pharmaceuticals |
Efficacy
Efficacy of Opdivo (Nivolumab) in Lung Cancer
Opdivo (Nivolumab) is a programmed death receptor-1 (PD-1) blocking antibody indicated for the treatment of patients with metastatic non-small cell lung cancer (NSCLC) with progression on or after platinum-based chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving Opdivo. Clinical trials have demonstrated that Opdivo can significantly improve overall survival in NSCLC patients compared to chemotherapy. The efficacy of Opdivo has been established in several studies, including the pivotal Phase III CheckMate-057 trial, which showed improved survival outcomes in previously treated NSCLC patients.
In the CheckMate-057 trial, patients treated with Opdivo experienced a median overall survival of 12.2 months compared to 9.4 months for those on docetaxel chemotherapy. Moreover, the one-year survival rate was 51% for patients receiving Opdivo versus 39% for the docetaxel group. It is important to note that the efficacy of Opdivo can vary based on the PD-L1 expression level, histology of lung cancer, and prior treatments received by the patient.
Efficacy of Afinitor (Everolimus) in Lung Cancer
Afinitor (Everolimus) is an mTOR inhibitor that is used in various types of cancer, including advanced renal cell carcinoma and certain types of breast cancer. However, its use in lung cancer is considered off-label, and the evidence for its efficacy in this setting is less established compared to its use in other cancers. In the context of lung cancer, everolimus has been studied in clinical trials as a single agent or in combination with other therapies. The results have shown some promise in terms of disease stabilization and progression-free survival in subsets of patients, particularly in those with advanced, progressive neuroendocrine tumors of pulmonary origin.
Despite some positive findings, the use of Afinitor in lung cancer is not as widely recognized or approved as in other types of cancer. Clinical trials continue to explore its potential benefits, often in combination with other targeted therapies or chemotherapeutic agents. It is crucial for healthcare providers to consider the individual patient's disease characteristics and treatment history when contemplating the off-label use of Afinitor for lung cancer, and to rely on the latest clinical evidence to guide their decisions.
Regulatory Agency Approvals
Opdivo
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European Medical Agency (EMA), European Union
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Food and Drug Administration (FDA), USA
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Health Canada
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Pharmaceuticals and Medical Devices Agency (PMDA), Japan
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Therapeutic Goods Administration (TGA), Australia
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Medsafe (NZ)
Afinitor
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European Medical Agency (EMA), European Union
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Food and Drug Administration (FDA), USA
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Health Canada
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Pharmaceuticals and Medical Devices Agency (PMDA), Japan
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Therapeutic Goods Administration (TGA), Australia
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