Opdivo (Nivolumab) vs Augtyro (repotrectinib)

Opdivo (Nivolumab) is an immune checkpoint inhibitor specifically targeting the PD-1 receptor, commonly used for various types of cancer, including melanoma, lung cancer, and kidney cancer, by enhancing the body's immune response against cancer cells. Augtyro (repotrectinib), on the other hand, is a tyrosine kinase inhibitor designed to target cancers with specific genetic alterations, such as NTRK fusions, ROS1, or ALK-positive tumors, and is used in patients whose cancer has these specific mutations. The choice between Opdivo and Augtyro would depend on the genetic makeup of the cancer, the specific type of cancer being treated, and the overall health and treatment goals of the patient, with genetic testing and consultation with an oncologist being essential to make an informed decision.

Difference between Opdivo and Augtyro

Metric	Opdivo (Nivolumab)	Augtyro (repotrectinib)
Generic name	Nivolumab	Repotrectinib
Indications	Various types of cancers, including melanoma, non-small cell lung cancer, renal cell carcinoma, Hodgkin lymphoma, head and neck cancer, urothelial carcinoma, and colorectal cancer	Advanced solid tumors with NTRK gene fusions, ROS1+ non-small cell lung cancer
Mechanism of action	Programmed death receptor-1 (PD-1) blocking antibody, enhancing the immune response against cancer cells	Tyrosine kinase inhibitor targeting TRK, ROS1, and ALK
Brand names	Opdivo	Augtyro
Administrative route	Intravenous infusion	Oral
Side effects	Fatigue, rash, musculoskeletal pain, pruritus, diarrhea, nausea, decreased appetite, cough	Dizziness, constipation, fatigue, edema, dyspnea, pleural effusion, cough, nausea, vomiting
Contraindications	Hypersensitivity to nivolumab or any of its excipients	Hypersensitivity to repotrectinib or any of its excipients
Drug class	Immune checkpoint inhibitor	Tyrosine kinase inhibitor
Manufacturer	Bristol Myers Squibb	Turning Point Therapeutics, Inc.

Efficacy

Efficacy of Opdivo (Nivolumab) in Lung Cancer

Opdivo (Nivolumab) is a programmed death receptor-1 (PD-1) blocking antibody used in the treatment of various forms of cancer, including lung cancer. In non-small cell lung cancer (NSCLC), Opdivo has shown significant efficacy, particularly in patients with previously treated metastatic NSCLC. Clinical trials have demonstrated that Opdivo can improve overall survival compared to standard chemotherapy. The efficacy of Opdivo is particularly notable in patients whose tumors express PD-L1, although it has also shown benefits in the broader NSCLC patient population.

Opdivo works by inhibiting the interaction between PD-1 and its ligands, PD-L1 and PD-L2, which can otherwise lead to the inhibition of the immune response against cancer cells. By blocking this interaction, Opdivo enables the immune system to better recognize and attack cancer cells. The use of Opdivo may vary based on the histology of the lung cancer, prior treatments, and the presence of specific genetic markers.

Efficacy of Augtyro (repotrectinib) in Lung Cancer

Augtyro (repotrectinib) is an investigational new drug that targets the tropomyosin receptor kinase (TRK), ROS1, and anaplastic lymphoma kinase (ALK) tyrosine kinases. It is designed for the treatment of patients with non-small cell lung cancer (NSCLC) who have specific genetic alterations, namely ROS1 or NTRK fusions. As of the knowledge cutoff date, Augtyro is still in clinical development, and its efficacy is being evaluated in ongoing clinical trials. The preliminary data from these trials suggest that Augtyro has activity against NSCLC harboring these genetic alterations, with patients experiencing tumor shrinkage and prolonged periods of disease control.

Repotrectinib has been designed to overcome resistance to prior ROS1 or ALK tyrosine kinase inhibitors, which is a common challenge in the treatment of NSCLC with these mutations. The efficacy of Augtyro in lung cancer patients who have developed resistance to earlier treatments is an area of particular interest, and ongoing studies are aimed at determining its effectiveness in this context. As with any investigational therapy, the final assessment of Augtyro's efficacy will depend on the outcomes of these clinical trials and subsequent approval by regulatory agencies.

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)

Augtyro

Food and Drug Administration (FDA), USA

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