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What is the difference between Opdivo and Keytruda?

Medically reviewed by Philip Thornton, DipPharm. Last updated on Sep 3, 2021.

Official answer


Opdivo (nivolumab) and Keytruda (pembrolizumab) are two immunotherapy drugs used to treat a number of different types of cancer. They are monoclonal antibodies that have similar efficacy and safety profiles and are both programmed death receptor-1 (PD1) inhibitors, which were first approved in the US in 2014.

Opdivo is marketed by Bristol Myers Squibb and Keytruda is marketed by Merck & Co.

The key differences between Opdivo and Keytruda are seen in the dosing frequency, the drugs they are used in combination with and the types of cancer they have been approved for use in.

Opdivo vs Keytruda: Dosing frequency

Opdivo is administered via a 30-60 min intravenous (IV) infusion every 2-4 or 6 weeks, whereas Keytruda is administered slightly less frequently. Keytruda is administered via a 30 min IV infusion every 3-6 weeks.

Opdivo vs Keytruda: Combination therapy

When used in combination with other drugs, Opdivo is used alongside:

  • Ipilimumab (Yervoy)
  • Platimum-doublet chemotherapy
  • Carbozantinib (Cabometyx)

When used in combination with other drugs, Keytruda is used alongside:

  • 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.

Opdivo vs Keytruda: Uses

Keytruda has been approved for use in a number of cancer types that Opdivo is not approved for use in including:

  • As a single-agent, first-line treatment for stage III or metastatic non-small cell lung cancer (NSCLC) expressing programmed death-ligand 1 (PD-L1). Both drugs are also approved for second-line therapy of NSCLC and in combination with other agents.
  • Primary mediastinal large B-cell lymphoma
  • Cervical cancer
  • Merkel cell carcinoma
  • Endometrial carcinoma
  • Tumor mutational burden-high cancer
  • Triple-negative breast cancer

On the other hand, Opdivo was the first to be approved for the adjuvant treatment of patients with high-risk urothelial carcinoma, although both Opdivo and Keytruda are used for treating other patients with advanced or metastatic urothelial carcinoma.


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