What is the difference between Opdivo and Keytruda?
Opdivo (nivolumab) and Keytruda (pembrolizumab) are two immunotherapy drugs used to treat various cancers. Both are monoclonal antibodies, known as PD1 inhibitors, first approved in 2014. Opdivo is from Bristol Myers Squibb, and Keytruda is from Merck & Co.
The main differences lie in their dosing, what other treatments they are recommended with, and what cancers they are approved to treat.
Opdivo Vs Keytruda Dosing Frequency
Opdivo: Given via IV infusion over 30 minutes every 2 to 4 weeks depending on the cancer you have.
Opdivo Qvantig: This is a new formulation of Opdivo that contains hyaluronidase that allows it to be given subcutaneously (under the skin) over 3 to 5 minutes every 2, 3, or 4 weeks depending on the dose and the cancer you have (see Opdivo Vs Opdivo Qvantig: What is the difference?).
Keytruda: Given via IV infusion over 30 minutes every 3-6 weeks.
Opdivo Vs Keytruda Combination Therapy
Opdivo Combination Treatment
Depending on the cancer being treated, Opdivo is used in combination with:
Opdivo Qvantig shares solid tumor FDA approvals with Opdivo, but it is not approved for use in classical Hodgkin lymphoma (cHL), malignant pleural mesothelioma, or in children. It is also not approved for use in combination with Yervoy, but is approved for use with Cabometyx or chemotherapy.
Keytruda Combination Treatment
Depending on the cancer being treated, Keytruda is used in combination with:
- Pemetrexed (Alimta) and platinum chemotherapy
- Carboplatin (Paraplatin) and either paclitaxel or paclitaxel protein-bound (Abraxane)
- Platinum and flurouracil
- Trastuzumab (Herceptin) plus fluoropyrimidine- and platinum-containing chemotherapy
- Axitinib (Inlyta)
- Lenvatinib (Lenvima)
- Chemotherapy.
Both drugs are also used alongside fluoropyrimidine- and platinum-containing chemotherapy for treating certain gastric cancers.
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Opdivo Vs Keytruda Approved Uses
Keytruda is approved for additional cancer types, including non-small cell lung cancer (as a first-line treatment), cervical cancer, Merkel cell carcinoma, Primary mediastinal large B-cell lymphoma, endometrial carcinoma, biliary tract cancer, tumor mutational burden-high cancer, and triple-negative breast cancer.
Opdivo was the first for adjuvant treatment of high-risk urothelial carcinoma, and is also used for pleural mesothelioma (cancer that affects the lining of the lungs and chest wall), and colorectal cancer.
Both are used for various other cancers, including:
- skin cancers
- lung cancer
- kidney cancer
- classical Hodgkin lymphoma
- cancer of the stomach and esophagus
- squamous cell cancer
- bladder cancer
- liver cancer.
*There are slight differences in approval specifics between Opdivo and Keytruda, such as if they are approved first-line or just for advanced (metastatic) cancer.
Opdivo Qvantig is only approved for:
- Melanoma
- Bladder cancer (urothelial carcinoma)
- Colorectal cancer
- Gastric cancer, gastroesophageal junction cancer, and esophageal cancer
- Kidney cancer (renal cell carcinoma)
- Liver cancer (hepatocellular carcinoma)
- Non-small cell lung cancer (NSCLC)
- Squamous cell cancer of the head and neck.
References
- Opdivo Prescribing Information. https://packageinserts.bms.com/pi/pi_opdivo.pdf
- Opdivo Qvantig Prescribing Information. https://packageinserts.bms.com/pi/pi_opdivo-qvantig.pdf
- Keytruda Prescribing Information. https://www.merck.com/product/usa/pi_circulars/k/keytruda/keytruda_pi.pdf
Read next
Pembrolizumab vs. nivolumab: How do they compare?
Pembrolizumab and nivolumab are both prescription medications used to treat various types of cancers, including solid tumors and blood cancers. They may be used alone or in combination with other medicines for cancers that are more advanced, have spread in the body, or are no longer responding to previous treatments. Continue reading
Can you take prednisone with Keytruda?
You should only use prednisone with Keytruda if your doctor has specifically prescribed these medicines for you. Prednisone is in a class of drugs known as corticosteroids. Prednisone may be used to treat serious or life-threatening immune-mediated side effects that may occur due to Keytruda treatment. Continue reading
Is Keytruda covered by Medicare / Medicaid?
Keytruda is usually covered by Medicare or Medicaid, but your costs can vary depending upon your plan coverage. For example, with a Medicare Advantage plan, 41% of patients had no out-of-pocket costs for the 200 mg dose of Keytruda. Most patients with Medicaid typically pay from $4 to $8 per Keytruda infusion. Your costs may be different based on your overall income, deductible or health plan. Continue reading
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