| Renal Cell Carcinoma
Opdivo vs Afinitor
Side-by-side clinical, coverage, and cost comparison for renal cell carcinoma.Deep comparison between: Opdivo vs Afinitor 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 signalsAfinitor has a higher rate of injection site reactions vs Opdivo based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Afinitor but not Opdivo, including UnitedHealthcare
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Category
Opdivo
Afinitor
At A Glance
IV infusion
Every 2 weeks or Every 4 weeks
PD-1 blocking antibody
Oral
Daily
mTOR 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
- Hormone receptor positive breast cancer
- Neuroendocrine tumor of pancreas
- Gastro-enteropancreatic neuroendocrine tumor
- Renal Cell Carcinoma
- Angiomyolipoma of kidney
- Subependymal Giant Cell Astrocytoma
- Seizures, Focal
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
Hormone receptor positive breast cancer 10 mg orally once daily in combination with exemestane until disease progression or unacceptable toxicity.
Neuroendocrine tumor of pancreas, Gastro-enteropancreatic neuroendocrine tumor 10 mg orally once daily until disease progression or unacceptable toxicity.
Renal Cell Carcinoma 10 mg orally once daily until disease progression or unacceptable toxicity.
Angiomyolipoma of kidney 10 mg orally once daily until disease progression or unacceptable toxicity.
Subependymal Giant Cell Astrocytoma Starting dose 4.5 mg/m2 orally once daily (AFINITOR or AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Seizures, Focal Starting dose 5 mg/m2 orally once daily (AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Contraindications
- Clinically significant hypersensitivity to everolimus or other rapamycin derivatives
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 (>=30%) Stomatitis, infections, rash, fatigue, diarrhea, decreased appetite.
Serious Non-infectious pneumonitis, infections, severe hypersensitivity reactions, angioedema, stomatitis, renal failure, impaired wound healing, metabolic disorders (hyperglycemia, dyslipidemia), myelosuppression, radiation sensitization and recall.
Postmarketing Thrombotic microangiopathy, cardiac failure (including with pulmonary hypertension), acute pancreatitis, cholecystitis, cholelithiasis, sepsis, reflex sympathetic dystrophy, arterial thrombotic events, lymphedema, radiation sensitization and recall.
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.
Everolimus is an mTOR inhibitor that binds the intracellular protein FKBP-12 to form an inhibitory complex with mTORC1, suppressing downstream effectors (S6K1, 4E-BP1) involved in protein synthesis, cell proliferation, and angiogenesis, and reducing HIF-1 and VEGF expression; mTOR pathway dysregulation occurs in several human cancers and in tuberous sclerosis complex.
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Most Common Insurance
Anthem BCBS
Opdivo
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (4/12) · Qty limit (0/12)
Afinitor
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Opdivo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Afinitor
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (6/8)
Humana
Opdivo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Afinitor
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Opdivo.
No savings programs available for Afinitor.
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OpdivoView full Opdivo profile
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.