Opdivo (Nivolumab) vs Odomzo (sonidegib)

Opdivo (Nivolumab) is an immune checkpoint inhibitor that works by blocking the PD-1 protein on T cells, thereby enhancing the immune system's ability to attack cancer cells, and is commonly used to treat a variety of cancers, including melanoma, non-small cell lung cancer, and kidney cancer. Odomzo (Sonidegib) is a hedgehog pathway inhibitor that specifically targets and inhibits a molecule called Smoothened, which is involved in the growth of cancer cells, and is approved for the treatment of locally advanced basal cell carcinoma (BCC) that has recurred following surgery or radiation therapy, or for patients who are not candidates for these therapies. When deciding between these two medications, it is important to consider the specific type of cancer being treated, as their mechanisms and approved uses differ significantly; a healthcare provider can offer guidance based on the individual's cancer type, stage, and overall health condition.

Difference between Opdivo and Odomzo

Metric	Opdivo (Nivolumab)	Odomzo (Sonidegib)
Generic name	Nivolumab	Sonidegib
Indications	Used for the treatment of melanoma, non-small cell lung cancer, renal cell carcinoma, Hodgkin lymphoma, head and neck cancer, urothelial carcinoma, and colorectal cancer.	Used for the treatment of locally advanced basal cell carcinoma (BCC) in patients who are not candidates for surgery or radiation.
Mechanism of action	Programmed death receptor-1 (PD-1) blocking antibody, which inhibits the PD-1/PD-L1 pathway, enhancing the immune response against tumor cells.	Hedgehog pathway inhibitor, which interferes with the Hedgehog signaling pathway that is active in basal cell carcinomas.
Brand names	Opdivo	Odomzo
Administrative route	Intravenous infusion	Oral
Side effects	Fatigue, rash, musculoskeletal pain, pruritus, diarrhea, nausea, weakness, upper respiratory tract infection, cough, difficulty breathing, decreased appetite, and headache.	Muscle spasms, alopecia, dysgeusia, fatigue, nausea, musculoskeletal pain, diarrhea, decreased weight, decreased appetite, myalgia, abdominal pain, headache, and vomiting.
Contraindications	Patients with hypersensitivity to nivolumab or any of its excipients.	Patients with hypersensitivity to sonidegib or any of its excipients, and women who are pregnant or breastfeeding.
Drug class	Immune checkpoint inhibitor	Hedgehog pathway inhibitor
Manufacturer	Bristol-Myers Squibb	Novartis

Efficacy

Opdivo (Nivolumab) Efficacy in Skin Cancer

Opdivo, known generically as Nivolumab, is a medication that has shown efficacy in treating skin cancer, specifically melanoma, which is the most dangerous form of skin cancer. As a programmed death receptor-1 (PD-1) blocking antibody, Opdivo enhances the immune system's ability to fight cancer cells. Clinical trials have demonstrated that Nivolumab can significantly improve survival rates in patients with metastatic melanoma. The drug has been approved for use in patients with melanoma that is inoperable or has spread to other parts of the body. It is also indicated for adjuvant treatment of melanoma with involvement of lymph nodes or in patients who have undergone complete resection, including those with Stage III and IV disease.

In a pivotal Phase III trial, Opdivo showed a significant improvement in overall survival compared to the chemotherapy agent dacarbazine. Patients receiving Opdivo experienced fewer severe side effects and had a delay in the progression of their skin cancer. Moreover, the benefits of Nivolumab were observed across various subgroups of patients, including those with different levels of PD-L1 expression, a protein that can suppress the immune response against cancer cells.

Odomzo (Sonidegib) Efficacy in Skin Cancer

Odomzo, with the active ingredient Sonidegib, is another medication that targets skin cancer, specifically advanced basal cell carcinoma (BCC) that has recurred after surgery or radiation therapy, or for patients who are not candidates for these therapies. Sonidegib is a hedgehog pathway inhibitor, which works by targeting a molecular pathway that is active in BCC cells. By inhibiting this pathway, Odomzo can slow or stop the growth of cancer cells.

Clinical studies have shown that Odomzo is effective in shrinking tumors in a significant number of patients with locally advanced BCC. In a multicenter, double-blind, randomized Phase II study, Sonidegib demonstrated a meaningful tumor response rate in patients with advanced BCC, with some patients achieving complete response. The duration of response has also been notable, with some patients maintaining tumor control for extended periods. However, the efficacy and safety of Odomzo in pediatric patients have not been established, and its use in such cases should be considered carefully against the potential risks.

Regulatory Agency Approvals

Opdivo

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Health Canada
Pharmaceuticals and Medical Devices Agency (PMDA), Japan
Therapeutic Goods Administration (TGA), Australia
Medsafe (NZ)

Odomzo

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Therapeutic Goods Administration (TGA), Australia

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