| Non-Small Cell Lung Carcinoma

Opdivo vs Zirabev

Side-by-side clinical, coverage, and cost comparison for non-small cell lung carcinoma.

Deep comparison between: Opdivo vs Zirabev with Prescriber.AI

AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.

Safety signalsZirabev has a higher rate of injection site reactions vs Opdivo based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Zirabev but not Opdivo, including UnitedHealthcare

Category

Opdivo

Zirabev

At A Glance

RouteIV infusion

FrequencyEvery 2 weeks or Every 4 weeks

ClassPD-1 blocking antibody

RouteIV infusion

FrequencyEvery 2-3 weeks

ClassVEGF inhibitor

Indications

melanoma
Non-Small Cell Lung Carcinoma
Malignant Pleural Mesothelioma
Renal Cell Carcinoma
Hodgkin Disease
Squamous cell carcinoma of the head and neck
Urothelial Carcinoma
Colorectal Carcinoma
Liver carcinoma
Squamous cell carcinoma of esophagus
Stomach Carcinoma
Gastroesophageal junction cancer
Adenocarcinoma Of Esophagus

Metastasis from malignant neoplasm of colon and/or rectum
Non-Small Cell Lung Carcinoma
Glioblastoma
Renal Cell Carcinoma
Cervix carcinoma
Malignant neoplasm of ovary
Fallopian Tube Carcinoma
Primary Peritoneal Cancer

Dosing

Melanoma Adults and pediatric >=40 kg: 240 mg every 2 weeks or 480 mg every 4 weeks; Pediatric <40 kg: 3 mg/kg every 2 weeks or 6 mg/kg every 4 weeks

Non-Small Cell Lung Carcinoma Neoadjuvant: 360 mg every 3 weeks with platinum-doublet chemotherapy for 3-4 cycles; Adjuvant after neoadjuvant: 480 mg every 4 weeks; Metastatic: 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks; or 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks and 2 cycles platinum-doublet chemotherapy; or 240 mg every 2 weeks or 480 mg every 4 weeks

Malignant Pleural Mesothelioma 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks

Renal Cell Carcinoma 3 mg/kg with ipilimumab 1 mg/kg every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks; or 240 mg every 2 weeks or 480 mg every 4 weeks with cabozantinib 40 mg daily orally; or 240 mg every 2 weeks or 480 mg every 4 weeks

Hodgkin Disease Previously untreated: Adults and pediatric >=40 kg: 240 mg with AVD every 2 weeks for 6 cycles; Pediatric <40 kg: 3 mg/kg with AVD every 2 weeks for 6 cycles; Relapsed or refractory: 240 mg every 2 weeks or 480 mg every 4 weeks

Squamous cell carcinoma of the head and neck 240 mg every 2 weeks or 480 mg every 4 weeks

Urothelial Carcinoma Adjuvant: 240 mg every 2 weeks or 480 mg every 4 weeks; First-line: 360 mg every 3 weeks with cisplatin and gemcitabine for up to 6 cycles, then 240 mg every 2 weeks or 480 mg every 4 weeks; Previously treated: 240 mg every 2 weeks or 480 mg every 4 weeks

Colorectal Carcinoma Adults and pediatric >=40 kg: 240 mg with ipilimumab 1 mg/kg every 3 weeks for maximum 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks; Pediatric <40 kg: 3 mg/kg with ipilimumab 1 mg/kg every 3 weeks for maximum 4 doses, then 3 mg/kg every 2 weeks or 6 mg/kg every 4 weeks

Liver carcinoma 1 mg/kg with ipilimumab 3 mg/kg every 3 weeks for 4 doses, then 240 mg every 2 weeks or 480 mg every 4 weeks

Squamous cell carcinoma of esophagus Adjuvant resected: 240 mg every 2 weeks or 480 mg every 4 weeks for 1 year; First-line with chemotherapy: 240 mg every 2 weeks or 480 mg every 4 weeks with fluoropyrimidine- and platinum-containing chemotherapy; First-line with ipilimumab: 3 mg/kg every 2 weeks or 360 mg every 3 weeks with ipilimumab 1 mg/kg every 6 weeks; Previously treated: 240 mg every 2 weeks or 480 mg every 4 weeks

Stomach Carcinoma 360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks or 240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks

Gastroesophageal junction cancer 360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks or 240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks

Adenocarcinoma Of Esophagus 360 mg every 3 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 3 weeks or 240 mg every 2 weeks with fluoropyrimidine- and platinum-containing chemotherapy every 2 weeks

Metastasis from malignant neoplasm of colon and/or rectum 5 mg/kg IV every 2 weeks with bolus-IFL; 10 mg/kg IV every 2 weeks with FOLFOX4; 5 mg/kg IV every 2 weeks or 7.5 mg/kg IV every 3 weeks with fluoropyrimidine-irinotecan- or fluoropyrimidine-oxaliplatin-based chemotherapy after progression on a first-line bevacizumab product-containing regimen.

Non-Small Cell Lung Carcinoma 15 mg/kg IV every 3 weeks in combination with carboplatin and paclitaxel.

Glioblastoma 10 mg/kg IV every 2 weeks.

Renal Cell Carcinoma 10 mg/kg IV every 2 weeks in combination with interferon alfa.

Cervix carcinoma 15 mg/kg IV every 3 weeks in combination with paclitaxel and cisplatin or paclitaxel and topotecan.

Malignant neoplasm of ovary, Fallopian Tube Carcinoma, Primary Peritoneal Cancer Stage III/IV following initial surgical resection: 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel for up to 6 cycles, followed by 15 mg/kg every 3 weeks as a single agent for up to 22 cycles. Platinum-resistant recurrent: 10 mg/kg IV every 2 weeks with paclitaxel, pegylated liposomal doxorubicin, or topotecan (weekly); or 15 mg/kg IV every 3 weeks with topotecan (every 3 weeks). Platinum-sensitive recurrent: 15 mg/kg IV every 3 weeks with carboplatin and paclitaxel or carboplatin and gemcitabine for 6-10 cycles, followed by 15 mg/kg every 3 weeks as a single agent.

Contraindications

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Drug Interactions

187View drug interactions

231View drug interactions

Adverse Reactions

Most common (>=20%) fatigue, musculoskeletal pain, rash, diarrhea, pruritus, nausea, decreased appetite, cough, dyspnea, constipation, upper respiratory tract infection

Serious pneumonitis, colitis, hepatitis, endocrinopathies, nephritis, dermatologic reactions, myocarditis, neurological toxicities, infusion-related reactions

Most common (>10%) Epistaxis, headache, hypertension, rhinitis, proteinuria, taste alteration, dry skin, hemorrhage, lacrimation disorder, back pain, exfoliative dermatitis.

Serious Gastrointestinal perforations and fistulae, surgery and wound healing complications, hemorrhage, arterial thromboembolic events, venous thromboembolic events, hypertension, posterior reversible encephalopathy syndrome, renal injury and proteinuria, infusion-related reactions, ovarian failure, congestive heart failure.

Postmarketing Polyserositis, pulmonary hypertension, mesenteric venous occlusion, gastrointestinal ulcer, intestinal necrosis, anastomotic ulceration, pancytopenia, gallbladder perforation, osteonecrosis of the jaw, renal thrombotic microangiopathy, nasal septum perforation, arterial aneurysms/dissections/rupture.

Pharmacology

Nivolumab is a PD-1 blocking antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2, releasing PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response.

Bevacizumab-bvzr binds VEGF and prevents its interaction with receptors Flt-1 and KDR on the surface of endothelial cells, inhibiting endothelial cell proliferation, new blood vessel formation, and metastatic disease progression.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Opdivo