Opdivo (Nivolumab) vs Ukoniq (umbralisib)

Opdivo (nivolumab) and Ukoniq (umbralisib) are both used in the treatment of certain cancers, but they work in different ways. Opdivo is a type of immunotherapy called a checkpoint inhibitor that helps the immune system recognize and attack cancer cells, and it's commonly used for cancers such as melanoma, non-small cell lung cancer, and kidney cancer. On the other hand, Ukoniq is a kinase inhibitor that targets specific pathways inside cancer cells to stop their growth and is used for treating marginal zone lymphoma and follicular lymphoma. When deciding between these two medications, it's essential to consider the specific type of cancer being treated, the patient's overall health, and the potential side effects, as each medicine is tailored to different cancer profiles and may not be interchangeable. It is crucial to consult with an oncologist who can provide a personalized recommendation based on the individual's medical history and the specific characteristics of their cancer.

Difference between Opdivo and Ukoniq

Metric	Opdivo (Nivolumab)	Ukoniq (umbralisib)
Generic name	Nivolumab	Umbralisib
Indications	Various types of cancers including melanoma, non-small cell lung cancer, kidney cancer, bladder cancer, head and neck cancer, and others	Marginal zone lymphoma (MZL) and follicular lymphoma (FL) after at least one prior anti-CD20-based regimen
Mechanism of action	Programmed death receptor-1 (PD-1) blocking antibody	PI3K delta and CK1 epsilon inhibitor
Brand names	Opdivo	Ukoniq
Administrative route	Intravenous infusion	Oral
Side effects	Fatigue, rash, musculoskeletal pain, pruritus, diarrhea, nausea, and others	Increased liver enzymes, diarrhea, fatigue, musculoskeletal pain, rash, and others
Contraindications	Severe hypersensitivity to nivolumab or any of its excipients	None specifically mentioned; however, should be used with caution in patients with severe hepatic impairment or severe renal impairment
Drug class	Immune checkpoint inhibitor	Small molecule kinase inhibitor
Manufacturer	Bristol-Myers Squibb	TG Therapeutics

Efficacy

Efficacy of Opdivo (Nivolumab) in Lymphoma

Opdivo (Nivolumab) is a programmed death receptor-1 (PD-1) blocking antibody used in cancer immunotherapy. It is particularly effective in treating certain types of lymphoma, including classical Hodgkin lymphoma (cHL) after relapse or after stem cell transplantation. Clinical trials have demonstrated that Nivolumab can induce a response in a significant proportion of these patients. The overall response rate (ORR) in relapsed or refractory cHL patients has been reported to be high, with many patients achieving partial or complete remission. However, the efficacy can vary based on prior treatments and the extent of the disease.

Efficacy of Opdivo (Nivolumab) in Other Lymphoma Subtypes

While Opdivo has shown promise in cHL, its efficacy in other lymphoma subtypes, such as non-Hodgkin lymphoma (NHL), is still being explored. The response rates in NHL subtypes like follicular lymphoma and diffuse large B-cell lymphoma (DLBCL) may be lower compared to cHL. Nevertheless, Nivolumab continues to be investigated in various combinations and settings to improve outcomes for patients with different lymphoma subtypes. Ongoing clinical trials are critical to understanding its full potential in the broader lymphoma patient population.

Efficacy of Ukoniq (Umbralisib) in Lymphoma

Ukoniq (Umbralisib) is a novel medication that targets the PI3K delta and CK1 epsilon pathways, which are often active in malignant B-cells. It is approved for the treatment of certain types of marginal zone lymphoma (MZL) and follicular lymphoma (FL) in patients who have received at least one prior anti-CD20-based regimen. Clinical trials have shown that Umbralisib can lead to durable responses in a subset of these patients. The ORR in MZL and FL has been found to be clinically meaningful, with a manageable safety profile. However, it is important to note that responses may vary, and not all patients will benefit from this treatment.

Comparative Efficacy and Considerations

When comparing the efficacy of Opdivo and Ukoniq in lymphoma, it is important to consider the specific lymphoma subtype and previous treatments the patient has undergone. Both medications have shown efficacy in their respective approved indications, but their roles in treatment may differ based on the disease context. Additionally, ongoing research and clinical trials may further define their place in therapy, including potential combination treatments and their use in other lymphoma subtypes. Physicians must weigh the benefits and risks of these medications and consider individual patient factors when making treatment decisions.

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)

Ukoniq

Food and Drug Administration (FDA), USA

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