| Renal Cell Carcinoma

Opdivo vs Temsirolimus - Temsirolimus

Side-by-side clinical, coverage, and cost comparison for renal cell carcinoma.
Deep comparison between: Opdivo vs Temsirolimus 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 signalsTemsirolimus has a higher rate of injection site reactions vs Opdivo based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Temsirolimus but not Opdivo, including UnitedHealthcare
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Opdivo
Temsirolimus
At A Glance
IV infusion
Every 2 weeks or Every 4 weeks
PD-1 blocking antibody
IV infusion
Once weekly
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
  • Renal Cell Carcinoma
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
Advanced Renal Cell Carcinoma 25 mg administered as an intravenous infusion over a 30-60 minute period once weekly; continue until disease progression or unacceptable toxicity. Premedicate with IV diphenhydramine 25-50 mg approximately 30 minutes before each dose.
Dose Modification - Hepatic Impairment Reduce dose to 15 mg/week in patients with mild hepatic impairment (bilirubin >1-1.5x ULN or AST >ULN but bilirubin <=ULN); contraindicated if bilirubin >1.5x ULN.
Dose Modification - Strong CYP3A4 Inhibitors Avoid concomitant use; if unavoidable, reduce dose to 12.5 mg/week and allow approximately 1-week washout after inhibitor discontinuation before returning to prior dose.
Dose Modification - Strong CYP3A4 Inducers Avoid concomitant use; if unavoidable, increase dose from 25 mg/week up to 50 mg/week, then return to prior dose once inducer is discontinued.
Dose Modification - Toxicity Hold for ANC or platelet nadirs meeting threshold criteria or NCI CTCAE grade >=3 adverse reactions; once resolved to grade <=2, restart at dose reduced by 5 mg/week to no lower than 15 mg/week.
Contraindications
    • Bilirubin >1.5x ULN
    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%) clinical adverse reactions Rash, asthenia, mucositis, nausea, edema, anorexia
    Most common (>=30%) laboratory abnormalities Anemia, hyperglycemia, hyperlipidemia, hypertriglyceridemia, lymphopenia, elevated alkaline phosphatase, elevated serum creatinine, hypophosphatemia, thrombocytopenia, elevated AST, leukopenia
    Serious Hypersensitivity/infusion reactions, hepatic impairment, hyperglycemia/glucose intolerance, infections, interstitial lung disease, hyperlipidemia, bowel perforation, renal failure, wound healing complications, intracerebral hemorrhage
    Postmarketing Angioedema, rhabdomyolysis, Stevens-Johnson Syndrome, complex regional pain syndrome (reflex sympathetic dystrophy), pancreatitis, cholecystitis, cholelithiasis, extravasation reactions (swelling, pain, warmth, erythema)
    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.
    Temsirolimus binds to the intracellular protein FKBP-12, and the resulting protein-drug complex inhibits mTOR (mammalian target of rapamycin), blocking its ability to phosphorylate downstream effectors p70S6k and S6 ribosomal protein, leading to G1 growth arrest in tumor cells and reduced levels of HIF-1, HIF-2 alpha, and vascular endothelial growth factor.
    Enter your patient's insuranceCheck specific coverage details for your patient.
    Most Common Insurance
    Anthem BCBS
    Opdivo
    • Covered on 5 commercial plans
    • PA (10/12) · Step Therapy (4/12) · Qty limit (0/12)
    View full coverage details ›
    Temsirolimus
    • Covered on 5 commercial plans
    • PA (9/12) · Step Therapy (0/12) · Qty limit (0/12)
    View full coverage details ›
    UnitedHealthcare
    Opdivo
    • Covered on 4 commercial plans
    • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
    View full coverage details ›
    Temsirolimus
    • Covered on 4 commercial plans
    • PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
    View full coverage details ›
    Humana
    Opdivo
    • Covered on 0 commercial plans
    • PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
    View full coverage details ›
    Temsirolimus
    • Covered on 0 commercial plans
    • PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
    View full coverage details ›
    Coverage data sourced from MMIT. Updated monthly.
    Savings
    No savings programs available for Opdivo.
    No savings programs available for Temsirolimus.
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    Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.