Nivolumab
| Biomarker requirement | Regimen | Setting | Conditions |
|---|---|---|---|
| Non-small cell lung cancer5 | |||
PD-L1 expression ≥ 1% | + platinum-based chemotherapy | Neoadj. early | High risk of recurrence |
PD-L1 expression ≥ 1% | + platinum-based chemotherapy | Neoadj. early | Then adjuvant monotherapy after surgery; High risk of recurrence |
PD-L1 expression ≥ 1% | Monotherapy | Adj. early | After neoadjuvant nivolumab + platinum-based chemotherapy and surgical resection; High risk of recurrence |
No sensitising EGFR mutation or ALK translocation | + ipilimumab and 2 cycles of platinum-based chemotherapy | 1L metastatic | None |
None | Monotherapy | 2L advanced | After prior chemotherapy |
| Mesothelioma1 | |||
None | + ipilimumab | 1L advanced | Pleural mesothelioma only |
| Colorectal cancer2 | |||
Mismatch repair deficient or microsatellite instability-high | + ipilimumab | 1L advanced | None |
Mismatch repair deficient or microsatellite instability-high | + ipilimumab | 2L metastatic | After prior fluoropyrimidine-based combination chemotherapy |
| Gastric and GEJ adenocarcinoma1 | |||
PD-L1 CPS ≥ 5, HER2-negative | + fluoropyrimidine- and platinum-based combination chemotherapy | 1L advanced | None |
| Oesophageal cancer5 | |||
None | Monotherapy | Adj. | After prior neoadjuvant chemoradiotherapy; Residual pathologic disease |
Tumour cell PD-L1 expression ≥ 1% | + fluoropyrimidine- and platinum-based combination chemotherapy | 1L advanced | Squamous cell carcinoma only |
PD-L1 CPS ≥ 5, HER2-negative | + fluoropyrimidine- and platinum-based combination chemotherapy | 1L advanced | Adenocarcinoma only |
Tumour cell PD-L1 expression ≥ 1% | + ipilimumab | 1L advanced | Squamous cell carcinoma only |
None | Monotherapy | 2L advanced | Squamous cell carcinoma only; After prior fluoropyrimidine- and platinum-based combination chemotherapy |
| Hepatocellular carcinoma1 | |||
None | + ipilimumab | 1L advanced | None |
| Renal cell carcinoma3 | |||
None | + cabozantinib | 1L advanced | None |
None | + ipilimumab | 1L advanced | Intermediate/poor-risk |
None | Monotherapy | 2L advanced | After prior therapy |
| Urothelial carcinoma3 | |||
Tumour cell PD-L1 expression ≥ 1% | Monotherapy | Adj. | Muscle-invasive only; After radical resection of MIUC; High risk of recurrence |
None | + cisplatin and gemcitabine | 1L advanced | None |
None | Monotherapy | 2L advanced | After failure of prior platinum-containing therapy |
| Melanoma3 | |||
None | Monotherapy | Adj. | After complete resection; Stage IIB or IIC melanoma, or melanoma with involvement of lymph nodes or metastatic disease |
None | + ipilimumab | Any line advanced | None |
None | Monotherapy | Any line advanced | None |
| Head and neck squamous cell carcinoma1 | |||
None | Monotherapy | 2L advanced | Progressing on or after platinum-based therapy |
| Hodgkin lymphoma3 | |||
None | + doxorubicin, vinblastine and dacarbazine (AVD) | 1L advanced | Classical Hodgkin lymphoma only; Stage III or IV |
None | + brentuximab vedotin | 2L | Classical Hodgkin lymphoma only; After one prior line of therapy; Aged 5 up to 30 years |
None | Monotherapy | 3L+ | Classical Hodgkin lymphoma only; After autologous stem cell transplant (ASCT) and treatment with brentuximab vedotin |
Full text of section 4.1 (therapeutic indications)
Melanoma OPDIVO as monotherapy is indicated for the adjuvant treatment of adults and adolescents 12 years of age and older with Stage IIB or IIC melanoma, or melanoma with involvement of lymph nodes or metastatic disease who have undergone complete resection (see section 5.1). OPDIVO as monotherapy or in combination with ipilimumab is indicated for the treatment of advanced (unresectable or metastatic) melanoma in adults and adolescents 12 years of age and older. Relative to nivolumab monotherapy, an increase in progression-free survival (PFS) and overall survival (OS) for the combination of nivolumab with ipilimumab is established only in patients with low tumour PD-L1 expression (see sections 4.4 and 5.1). Non-small cell lung cancer (NSCLC) OPDIVO in combination with platinum-based chemotherapy is indicated for the neoadjuvant treatment of resectable non-small cell lung cancer at high risk of recurrence in adult patients whose tumours have PD-L1 expression ≥ 1% (see section 5.1 for selection criteria). OPDIVO in combination with platinum-based chemotherapy as neoadjuvant treatment, followed by OPDIVO as monotherapy as adjuvant treatment, is indicated for the treatment of resectable non-small cell lung cancer at high risk of recurrence in adult patients whose tumours have PD-L1 expression ≥ 1% (see section 5.1 for selection criteria). OPDIVO in combination with ipilimumab and 2 cycles of platinum-based chemotherapy is indicated for the first-line treatment of metastatic non-small cell lung cancer in adults whose tumours have no sensitising EGFR mutation or ALK translocation. OPDIVO as monotherapy is indicated for the treatment of locally advanced or metastatic non-small cell lung cancer after prior chemotherapy in adults. Malignant pleural mesothelioma (MPM) OPDIVO in combination with ipilimumab is indicated for the first-line treatment of adult patients with unresectable malignant pleural mesothelioma. Renal cell carcinoma (RCC) OPDIVO in combination with ipilimumab is indicated for the first-line treatment of adult patients with intermediate/poor-risk advanced renal cell carcinoma (see section 5.1). OPDIVO in combination with cabozantinib is indicated for the first-line treatment of adult patients with advanced renal cell carcinoma (see section 5.1). OPDIVO as monotherapy is indicated for the treatment of advanced renal cell carcinoma after prior therapy in adults. Classical Hodgkin lymphoma (cHL) OPDIVO in combination with doxorubicin, vinblastine and dacarbazine (AVD) is indicated for adults and adolescents 12 years of age and older with previously untreated Stage III or IV classical Hodgkin lymphoma. OPDIVO in combination with brentuximab vedotin is indicated for the treatment of children 5 years of age and older, adolescents and adults up to 30 years of age with relapsed or refractory classical Hodgkin lymphoma after one prior line of therapy (see section 5.1). OPDIVO as monotherapy is indicated for the treatment of adult patients with relapsed or refractory classical Hodgkin lymphoma after autologous stem cell transplant (ASCT) and treatment with brentuximab vedotin. Squamous cell cancer of the head and neck (SCCHN) OPDIVO as monotherapy is indicated for the treatment of recurrent or metastatic squamous cell cancer of the head and neck in adults progressing on or after platinum-based therapy (see section 5.1). Urothelial carcinoma (UC) OPDIVO as monotherapy is indicated for the adjuvant treatment of adults with muscle invasive urothelial carcinoma (MIUC) with tumour cell PD-L1 expression ≥ 1%, who are at high risk of recurrence after undergoing radical resection of MIUC (see section 5.1). OPDIVO in combination with cisplatin and gemcitabine is indicated for the first-line treatment of adult patients with unresectable or metastatic urothelial carcinoma. OPDIVO as monotherapy is indicated for the treatment of locally advanced unresectable or metastatic urothelial carcinoma in adults after failure of prior platinum-containing therapy. Mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H) colorectal cancer (CRC) OPDIVO in combination with ipilimumab is indicated for the treatment of adult patients with mismatch repair deficient or microsatellite instability-high colorectal cancer in the following settings: - first-line treatment of unresectable or metastatic colorectal cancer; - treatment of metastatic colorectal cancer after prior fluoropyrimidine-based combination chemotherapy (see section 5.1). Oesophageal squamous cell carcinoma (OSCC) OPDIVO in combination with ipilimumab is indicated for the first-line treatment of adult patients with unresectable advanced, recurrent or metastatic oesophageal squamous cell carcinoma with tumour cell PD-L1 expression ≥ 1%. OPDIVO in combination with fluoropyrimidine- and platinum-based combination chemotherapy is indicated for the first-line treatment of adult patients with unresectable advanced, recurrent or metastatic oesophageal squamous cell carcinoma with tumour cell PD-L1 expression ≥ 1%. OPDIVO as monotherapy is indicated for the treatment of adult patients with unresectable advanced, recurrent or metastatic oesophageal squamous cell carcinoma after prior fluoropyrimidine- and platinum-based combination chemotherapy. Adjuvant treatment of oesophageal or gastro-oesophageal junction cancer (OC or GEJC) OPDIVO as monotherapy is indicated for the adjuvant treatment of adult patients with oesophageal or gastro-oesophageal junction cancer who have residual pathologic disease following prior neoadjuvant chemoradiotherapy (see section 5.1). Gastric, gastro-oesophageal junction (GEJ) or oesophageal adenocarcinoma OPDIVO in combination with fluoropyrimidine- and platinum-based combination chemotherapy is indicated for the first-line treatment of adult patients with HER2-negative advanced or metastatic gastric, gastro-oesophageal junction or oesophageal adenocarcinoma whose tumours express PD-L1 with a combined positive score (CPS) ≥ 5. Hepatocellular carcinoma (HCC) OPDIVO in combination with ipilimumab is indicated for the first-line treatment of adult patients with unresectable or advanced hepatocellular carcinoma. OPDIVO as monotherapy is indicated for the adjuvant treatment of adults with Stage IIB or IIC melanoma, or melanoma with involvement of lymph nodes or metastatic disease who have undergone complete resection (see section 5.1). OPDIVO as monotherapy or in combination with ipilimumab is indicated for the treatment of advanced (unresectable or metastatic) melanoma in adults (see section 4.2). OPDIVO in combination with ipilimumab is indicated for the first-line treatment of adult patients with intermediate/poor-risk advanced renal cell carcinoma (see sections 4.2 and 5.1). OPDIVO in combination with cisplatin and gemcitabine is indicated for the first-line treatment of adult patients with unresectable or metastatic urothelial carcinoma (see sections 4.2 and 5.1). - first-line treatment of unresectable or metastatic colorectal cancer (see sections 4.2 and 5.1); - treatment of metastatic colorectal cancer after prior fluoropyrimidine-based combination chemotherapy (see sections 4.2 and 5.1).
Label history
101 changes to the Opdivo label since 2015, 28 of them to the indications. Newest first, in the words of EMA's record of each procedure.
Changes