nivolumabNivolumab (nivolumab) - opdivo (opdivo) - You can buy in Israel excluded drug Bristol-Myers Squibb American pharmaceutical company, for the treatment of cancer. By blocking PD-1 protein release immune system cells to fight cancer tumors

Actively used in the United States and Israel in 2014.

The first and only PD-1 inhibitor, approved by the European Commission for application within the EU.

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The indications for it are -

  1. Treatment of melanoma :
  • metastatic melanoma, which can not be removed by surgery;
  • after treatment with a drug ipilimumab, which is not effective or has ceased to have effect;
  • if the tumor is an abnormal BRAF gene therapy attempts to BRAF inhibitors, and they either do not have the desired action, or have ceased.

2. Treatment of lung cancer (advanced stage non-small cell lung cancer). Opdivo drug may be used when cancer has spread or grown after treatment with platinum-based chemotherapy drugs.

Therapy with nivolumab

OPDIVO® (nivolumab) - immunotherapeutic drug PD-1 blocking receptor (PD-1) programmed cell death. The body receives intravenously, using a drip under the supervision of a physician. The infusion time is about 60 minutes. The doctor decides how many procedures you need.

Nivolumabom therapy is usually recommended every two weeks. It is stopped if the melanoma is growing, or the patient unacceptable side effects. Should this occur, the oncologist will decide on the delay or stop treatment, or give other medicines to relieve symptoms. The doctor does blood tests for the detection of side effects.

General recommendations for time and dosage of medication opdivo based on the results of clinical studies:

  • First week. The patient received a first infusion. They are given every two weeks.
  • In the area of ​​9 weeks the patient has a scan. Treatment continues every 2 weeks until side effects and works tolerant.

The doctor can give the individual purpose of nivolumabom treatment.

There is no information on the effectiveness and safety of the drug for children under eighteen years of age.

Precautionary measures

Prior to treatment, you must tell your doctor if you have:

  • Diseases of the immune system: ulcerative colitis, terminal ileitis, lupus.
  • He had surgery to organ transplantation.
  • Lung disease, breathing difficulties.
  • Abnormalities in liver function.
  • Other medical problems.
  • Pregnant or planning to become pregnant. The drug can harm the fetus. It is important to use contraception during treatment and for at least 5 months after it.
  • You can not breastfeed, no information as nivolumab passes into breast milk.
  • It is important to inform the doctor about all medications, including dietary supplements.

Results of clinical trials

After applying nivolumaba 32% decreased tumor size.

The clinical study involved 370 patients with unresectable or metastatic melanoma previously treated YERVOY® (Ipilimumab), as well as with BRAF positive cancer after failure of the application BRAF inhibitors. 268 patients were treated with nivolumaba. research task was - to identify the number of patients responding to therapy with opdivo, and set the length of these results. The age range of participants was 25-88 years.

The drug Opdivo no results for each patient, the results were Variability:

  • In 32% (38 of 120) that were treated with Opdivo, tumor decreased or disappeared.
  • In 28% (34 people) decreased tumor (partial response).
  • At 3% (4 people), tumor disappeared (complete response).
  • In 87% (33 of 38), treated via opdivo, malignant tumor has decreased or disappeared, the results of clinical trials at the time (6 months).

However nivolumab can trigger the immune system to attack healthy organs and tissues, affecting their work. These disorders are very serious and are a threat to life, they may arise in the course of therapy and after its completion.

Possible serious side effects of the drug Opdivo:

  1. Pneumonia: chest pain, shortness of breath, cough, or the appearance of its gain.
  2. Colitis: severe abdominal pain, diarrhea, increased number of stools, and a dark tarry stools (presence of blood).
  3. Hepatitis: dark urine, drowsiness, poor appetite, yellowing of the whites of the eyes and skin, pain in the liver area.
  4. kidney disease: loss of appetite, blood in the urine, a reduction in amount of urine, swelling of the ankles.
  5. Hormonal disorders (especially thyroid and pituitary): reduced voice, constipation, not passing or unusual headaches, fatigue, decrease or increase in body weight, changes in mood or behavior (reduced sex drive, irritability, forgetfulness), dizziness or fainting, hair loss , feeling cold.
  6. Abnormalities in the work of other bodies: a rash, muscle weakness, vision problems, pain in muscles and joints severe or permanent nature.

Receive timely medical help prevent more serious side effects after taking the drug Opdivo.

The most common undesirable effect in melanoma - a rash. Lung cancer noted: constipation, nausea, fatigue, confusion breath, poor appetite, pain in the muscles, bones and joints, cough.

During treatment, the physician examines the patient for the presence of these problems. May apply corticosteroids, temporary discontinuation of treatment or refusal to fully nivolumaba. It depends on the degree of symptoms exhibited.