Opdivo (Nivolumab) vs Epkinly (epcoritamab-bysp)

Opdivo (nivolumab) is an immune checkpoint inhibitor that targets the PD-1/PD-L1 pathway, commonly used in various types of cancer, including melanoma, lung cancer, and kidney cancer, to help the immune system recognize and attack cancer cells. Epkinly (epcoritamab-bysp), on the other hand, is a bispecific antibody designed to target CD20 on B cells and CD3 on T cells, potentially used for hematological malignancies such as non-Hodgkin lymphoma. When deciding between the two, it is crucial to consider the specific type of cancer being treated, as Opdivo is more broadly used across different cancers, while Epkinly is more specialized, and the decision should be made in consultation with an oncologist who can evaluate the individual's medical history and the specific characteristics of their cancer.

Difference between Opdivo and Epkinly

Metric	Opdivo (Nivolumab)	Epkinly (epcoritamab-bysp)
Generic name	Nivolumab	epcoritamab-bysp
Indications	Various types of cancers including melanoma, lung cancer, kidney cancer, bladder cancer, head and neck cancer, and more.	Currently under investigation for treatment of B-cell non-Hodgkin lymphoma.
Mechanism of action	PD-1 immune checkpoint inhibitor that activates the immune system to attack cancer cells.	Bispecific antibody targeting CD20 on B-cells and CD3 on T-cells to direct the immune system to attack B-cell tumors.
Brand names	Opdivo	Epkinly
Administrative route	Intravenous infusion	Intravenous infusion
Side effects	Fatigue, rash, musculoskeletal pain, pruritus, diarrhea, nausea, and others.	Currently being evaluated in clinical trials, but may include cytokine release syndrome, infusion-related reactions, and others.
Contraindications	Known hypersensitivity to nivolumab or any of its excipients.	Not yet fully established, but will likely include known hypersensitivity to epcoritamab or its excipients.
Drug class	Monoclonal antibody, Immune checkpoint inhibitor	Bispecific monoclonal antibody
Manufacturer	Bristol Myers Squibb	Genmab and AbbVie

Efficacy

Overview of Opdivo (Nivolumab) in Lymphoma Treatment

Opdivo, generically known as nivolumab, is a programmed death receptor-1 (PD-1) blocking antibody used in cancer immunotherapy. It is designed to harness the body's own immune system to fight cancer cells. In the context of lymphoma, Opdivo has shown efficacy in treating classical Hodgkin Lymphoma (cHL) after failure of autologous stem cell transplant (ASCT) or after at least two prior therapies when ASCT or multi-agent chemotherapy is not a treatment option. Clinical trials have demonstrated that nivolumab can induce response rates in a significant proportion of these patients, with some achieving complete remission. The drug's effectiveness in this setting provides a valuable option for patients with relapsed or refractory cHL.

Efficacy of Opdivo in Other Lymphoma Subtypes

While the primary approval for Opdivo in the context of lymphoma is for cHL, studies have also investigated its use in other types of non-Hodgkin lymphoma (NHL). However, the efficacy in NHL subtypes other than cHL has been more variable, and Opdivo is not widely indicated for these other forms. It is important for clinicians to consider the specific subtype of lymphoma when evaluating the potential benefits of Opdivo, as the response rates and outcomes can differ significantly across the diverse spectrum of lymphomas.

Introduction to Epkinly (epcoritamab-bysp) in Lymphoma

Epkinly, with the active substance epcoritamab-bysp, is a bispecific antibody targeting both CD20, a protein found on the surface of B-cells, and CD3, a protein on T-cells. This dual targeting mechanism is designed to redirect T-cells to engage and eliminate B-cell lymphomas. While still under investigation in clinical trials, preliminary data have suggested that epcoritamab may have promising activity in the treatment of B-cell non-Hodgkin lymphoma (B-NHL), including in patients with relapsed or refractory disease. These studies are essential in determining the potential role of Epkinly in the therapeutic landscape of lymphoma.

Current Status of Epkinly in Clinical Development

As of the current knowledge cutoff, Epkinly is undergoing clinical trials to further evaluate its efficacy and safety profile in patients with B-cell lymphomas. The outcomes of these trials are anticipated to provide more definitive evidence regarding the drug's efficacy and could potentially lead to its approval for use in specific lymphoma subtypes. It is important for healthcare professionals to stay updated with the latest clinical data to make informed decisions about the potential incorporation of Epkinly into treatment regimens for lymphoma patients.

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)

Epkinly

Food and Drug Administration (FDA), USA

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