How effective are Opdivo and Yervoy when taken together?

Opdivo (nivolumab) and Yervoy (ipilimumab) are two anticancer medications. While they are both effective treatment options for many different types of cancer, research shows they work better when taken together for some types of cancer.

What are Opdivo and Yervoy?

Opdivo and Yervoy are two types of immunotherapy. They are both injectable medications that may be used to treat different types of cancer.

Opdivo is a programmed death receptor-1 (PD-1)-blocking antibody. It works to treat cancer by blocking a protein called PD-1 on immune cells, allowing them to better recognize and attack cancer cells. Opdivo is FDA approved to treat:

• Melanoma
• Non-small cell lung cancer
• Malignant pleural mesothelioma
• Renal cell carcinoma
• Classical Hodgkin lymphoma
• Squamous cell carcinoma of the head and neck
• Urothelial carcinoma
• Colorectal cancer
• Hepatocellular carcinoma
• Esophageal cancer
• Gastric cancer
• Gastroesophageal junction cancer

Yervoy is a human cytotoxic T-lymphocyte antigen 4 (CTLA-4)-blocking antibody. CTLA-4 is a protein on T cells that works to stop them from killing other cells, such as cancer cells. By blocking the actions of CTLA-4, Yervoy strengthens T-cell activation and responsiveness against cancer cells. Yervoy is FDA approved to treat:

• Melanoma
• Renal cell carcinoma
• Colorectal cancer
• Hepatocellular carcinoma
• Non-small cell lung cancer
• Malignant pleural mesothelioma
• Esophageal cancer

Why are Opdivo and Yervoy taken together?

Taking Opdivo and Yervoy together results in stronger T-cell function that exceeds the effects of either medication alone. This is because they work in different ways. Patients who have taken these two medications together saw improved anti-tumor responses in metastatic melanoma and advanced RCC. In animal studies, blocking both PD-1 and CTLA-4 by giving both Opdivo and Yervoy resulted in higher anti-tumor activity.

Opdivo and Yervoy may be used as combination therapy for melanoma, non-small cell lung cancer, malignant pleural mesothelioma, renal cell carcinoma, hepatocellular carcinoma, esophageal cancer, and colorectal cancer.

How effective are Opdivo and Yervoy?

The effectiveness of taking Opdivo and Yervoy depends on the individual person and what type of cancer they are treating. Below we will review data from clinical trials where patients took these two medications together.

Melanoma

In a clinical trial called CHECKMATE-067, patients with previously treated metastatic melanoma were given Opdivo, Opdivo and Yervoy followed by Opdivo, or Yervoy. The study was not designed to determine if taking Yervoy and Opvido together improved progression-free survival or overall survival. However, researchers found that patients who took Opdivo and Yervoy together had an overall survival rate of 58% compared to 52% of patients who took Yervoy alone and 34% of patients who took Opdivo alone at 36 months after starting treatment.

Related questions

• What are monoclonal antibodies?
• How long does Opdivo prolong life and what’s its success rate?
• How long does Opdivo take to work and how do you know if it's working?

Non-small cell lung cancer (NSCLC)

In a clinical trial called CHECKMATE-227, patients with metastatic or recurrent NSCLC were given Opdivo and Yervoy or platinum-doublet chemotherapy for up to 24 months. The overall survival in patients taking Yervoy and Opdivo was 15 to 20.1 (median 17.1) months compared to 12.7 to 16.7 (median 14.9) months for patients taking platinum-doublet chemotherapy.

Malignant pleural mesothelioma

In a clinical trial called CHECKMATE-743, patients with unresectable malignant pleural mesothelioma were given Opdivo and Yervoy, cisplatin, or carboplatin and pemetrexed for up to 2 years. The overall survival in patients taking Opdivo and Yervoy was 16.8 to 21.5 (median 18.1) months, compared to 12.5 to 16.2 (median 14.1) months for patients taking chemotherapy.

Renal cell carcinoma (RCC)

In a clinical trial called CHECKMATE-214, patients with previously untreated advanced RCC were given Opdivo and Yervoy followed by Opdivo, or sunitinib. The complete response rate in patients who took Opdivo and Yervoy was 9.4% compared to 1.2% in patients who took sunitinib. The overall survival in patients taking Opdivo and Yervoy was 55.7 months (median) compared to 38.4 months (median) for patients taking sunitinib. The median follow-up was 67.7 months.

Hepatocellular carcinoma

In a clinical trial called CHECKMATE-040, patients with hepatocellular carcinoma who progressed on or were intolerant to sorafenib were given Opdivo or Opdivo and Yervoy followed by Opdivo. The complete response rate was 8% in patients taking Opdivo and Yervoy, and the partial response rate was 24% per RECIST v1.1 (a standard way to measure tumor response of treatment). The minimum follow-up was 28 months.

Esophageal cancer

In a clinical trial called CHECKMATE-648, patients with previously untreated unresectable advanced, recurrent or metastatic esophageal squamous cell carcinoma were given one of the following treatments:

• Opdivo, fluorouracil, and cisplatin
• Opdivo and Yervoy
• Fluorouracil and cisplatin

The overall survival in patients taking Opdivo, fluorouracil, and cisplatin was 11.1 to 15.7 months (median 13.2 months). In patients taking Opdivo and Yervoy, the overall survival was 11.3 to 15.5 months (median 12.8 months). In patients taking cisplatin and fluorouracil, the overall survival was 9.4 to 11.9 months (median 10.7 months). The complete response rate was 13.4%, 11.1%, and 6.2%, respectively. The minimum follow-up was 29 months.

Colorectal cancer

In a clinical trial called CHECKMATE-142, patients with metastatic colorectal cancer were given Opdivo or Opdivo and Yervoy followed by Opdivo. The complete response rate in patients taking Opdivo and Yervoy together was 14% compared to 11% in patients taking Opdivo alone. The median follow-up was 29 months.

This is not all the information you need to know about Opdivo (nivolumab) and Yervoy (ipilimumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.