Opdivo (Nivolumab) vs Imjudo (tremelimumab)

Opdivo (nivolumab) and Imjudo (tremelimumab) are both immunotherapy drugs that work by stimulating the body's immune system to attack cancer cells, but they target different proteins. Nivolumab blocks the PD-1 protein on T cells, thereby enhancing the immune response against cancer cells, and is approved for various types of cancer, including melanoma, non-small cell lung cancer, and kidney cancer. Tremelimumab targets the CTLA-4 protein on T cells and is typically investigated for use in combination with other therapies; it has a different set of clinical trials and approvals, so the decision on which medication is appropriate would depend on the specific cancer type, stage, and the individual patient's medical history.

Difference between Opdivo and Imjudo

Metric	Opdivo (Nivolumab)	Imjudo (tremelimumab)
Generic name	Nivolumab	Tremelimumab
Indications	Various types of cancers including melanoma, lung cancer, renal cancer, Hodgkin lymphoma, and others	Unresectable or metastatic hepatocellular carcinoma in combination with durvalumab
Mechanism of action	PD-1 immune checkpoint inhibitor that activates T cells to attack cancer cells	CTLA-4 immune checkpoint inhibitor that helps to activate the immune system to attack cancer cells
Brand names	Opdivo	Imjudo
Administrative route	Intravenous infusion	Intravenous infusion
Side effects	Fatigue, rash, musculoskeletal pain, pruritus, diarrhea, nausea, and others	Fatigue, diarrhea, musculoskeletal pain, pruritus, rash, abdominal pain, and others
Contraindications	Known hypersensitivity to nivolumab or any of its excipients	Known hypersensitivity to tremelimumab or any of its excipients
Drug class	Programmed death receptor-1 (PD-1) blocking antibody	Cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) blocking antibody
Manufacturer	Bristol Myers Squibb	AstraZeneca

Efficacy

Efficacy of Opdivo (Nivolumab) in Liver Cancer

Opdivo (nivolumab) is a programmed death-1 (PD-1) immune checkpoint inhibitor that has shown efficacy in the treatment of liver cancer, specifically hepatocellular carcinoma (HCC), which is the most common type of primary liver cancer. Nivolumab works by blocking the PD-1 pathway, which in turn enhances the body's immune response against cancer cells. In clinical trials, nivolumab has demonstrated an ability to improve overall survival rates and to provide durable responses in some patients with advanced HCC who have previously been treated with sorafenib, a standard treatment for liver cancer.

The CheckMate-040 trial, a pivotal phase I/II study, evaluated the safety and efficacy of nivolumab in patients with advanced HCC. The results indicated that nivolumab provided a survival benefit with an acceptable safety profile. The objective response rate (ORR) observed in this study provided evidence of nivolumab's potential as a therapeutic option for patients with HCC who have limited treatment options after first-line therapy. Based on the outcomes of this trial, nivolumab received accelerated approval from the FDA for use in patients with HCC previously treated with sorafenib.

Efficacy of Imjudo (Tremelimumab) in Liver Cancer

Imjudo (tremelimumab) is a cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) blocking antibody that has been studied for its efficacy in treating HCC. Tremelimumab's mechanism of action involves the enhancement of the immune system's ability to fight cancer by blocking the CTLA-4 checkpoint, which can suppress the immune response. While tremelimumab has been investigated as a monotherapy, its efficacy in liver cancer has also been evaluated in combination with other immunotherapies, such as durvalumab, a PD-L1 inhibitor.

Early clinical trials have shown that the combination of tremelimumab and durvalumab can lead to antitumor activity in HCC. The rationale behind combining these two agents is to target different immune checkpoints and potentially provide a synergistic effect to improve patient outcomes. Although the data on tremelimumab as a monotherapy in HCC is limited, ongoing studies are assessing the efficacy and safety of this combination therapy in patients with advanced HCC. The results of these studies are anticipated to further define the role of tremelimumab in the treatment landscape of liver cancer.

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)

Imjudo

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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