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NICE publish guideline for use of Opdivo▼ with Yervoy in treating kidney cancer under Cancer Drug Fund

Opdivo▼, for Renal cell carcinoma and Kidney cancer from Bristol-Myers Squibb

The National Institute for Health and Care Excellence (NICE) have published their guideline for the use of the combination of:
  • Nivolumab (brand name Opdivo▼) with
  • Ipilimumab (brand name Yervoy)
as an option for adults with untreated advanced renal cell carcinoma (kidney cancer).

NICE recommend use within the Cancer Drugs Fund.

The criteria for use is that the kidney cancer is intermediate- or poor-risk.

It is recommended only if the conditions in the managed access agreement for nivolumab with ipilimumab are followed.

Managed access schemes are agreements between the manufacturer and the NHS, usually specifying a set of conditions under which reimbursement for the medicine will be made.

You can follow developments on Opdivo and Yervoy by using our Medicines Tracker service which provides users with updates about the medicines they are interested in.

About Opdivo (source EMA)
Opdivo is a cancer medicine used to treat the following:
  • melanoma, a type of skin cancer. Opdivo is used on its own or with another cancer medicine, ipilimumab, to treat adults whose cancer has spread to other parts of the body or cannot be surgically removed. It is also used on its own in patients who have had surgery for the removal of melanoma that has spread to the lymph nodes or elsewhere in the body.
  • a lung cancer called non-small cell lung cancer (NSCLC) that has spread locally or to other parts of the body. Opdivo is used on its own in patients who have previously been treated with other cancer medicines (chemotherapy);
  • advanced renal cell carcinoma, a kidney cancer. Opdivo is used on its own in patients who have been previously treated with other cancer medicines; it is used in combination with ipilimumab (another cancer medicine) in patients with previously untreated disease that is considered to be at moderate or high risk of worsening;
  • classical Hodgkin lymphoma, a cancer of the lymphocytes (a type of white blood cell), that has not improved or has returned after an autologous stem cell transplant (a procedure where the bone marrow is replaced with the patient’s own stem cells to form new bone marrow that produces healthy blood cells). Opdivo is used on its own after treatment with brentuximab vedotin (another cancer medicine);
  • squamous cell cancer of the head and neck (SCCHN) that has come back or spread to other parts of the body. Opdivo is used on its own in patients whose cancer is progressing despite treatment with platinum-based cancer medicines
  • urothelial cancer, a cancer of the bladder and urinary tract, that has spread locally and cannot be surgically removed or has spread to other parts of the body. It is used on its own when treatment with platinum-based cancer medicines has not worked.
The active substance in Opdivo, nivolumab, is a monoclonal antibody, a type of protein that has been designed to recognise and attach to a receptor (target) called PD-1 found on certain cells of the immune system called T cells.

Cancer cells can produce proteins (PD-L1 and PD-L2) that attach to this receptor and switch off the activity of the T cells, preventing them from attacking the cancer. By attaching to the receptor, nivolumab prevents PD-L1 and PD-L2 from switching off the T cells, thereby increasing the ability of the immune system to kill cancer cells.

Opdivo was first made available in the EU in 2015. It is manufactured by Bristol-Myers Squibb.

Sources
European Medicines Agency website page for Opdivo
NICE website
Accessed 17/05/19
Links available in full article

© NICE [2019]

Nivolumab with ipilimumab for untreated advanced renal cell carcinoma. Technology appraisal guidance [TA581] Published date: 15 May 2019
Available from: See Link below. All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.

The information provided by NICE was accurate at the time this article was issued.


Nivolumab with ipilimumab for untreated advanced renal cell carcinoma

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