Keytruda vs OPDIVO: Immunotherapy Comparison
Comprehensive comparison of Keytruda (pembrolizumab) and OPDIVO (nivolumab), two leading PD-1 checkpoint inhibitor immunotherapy drugs for cancer treatment.
| Feature | Keytruda (Pembrolizumab) | OPDIVO (Nivolumab) |
|---|---|---|
| Mechanism of Action | PD-1 checkpoint inhibitor - blocks PD-1 receptor on T cells | PD-1 checkpoint inhibitor - blocks PD-1 receptor on T cells |
| Approved Indications | Melanoma, NSCLC, head/neck cancer, Hodgkin lymphoma, urothelial carcinoma, MSI-H/dMMR cancers, gastric cancer, cervical cancer, hepatocellular carcinoma, Merkel cell carcinoma, renal cell carcinoma, esophageal cancer | Melanoma, NSCLC, renal cell carcinoma, Hodgkin lymphoma, head/neck cancer, urothelial carcinoma, MSI-H/dMMR CRC, hepatocellular carcinoma, esophageal cancer, malignant pleural mesothelioma, gastric cancer |
| Standard Dosing | 200mg IV every 3 weeks or 400mg every 6 weeks | 240mg IV every 2 weeks or 480mg every 4 weeks |
| Clinical Efficacy | Response rates 30-45% in first-line melanoma, 20-30% in NSCLC | Response rates 28-40% in first-line melanoma, 19-27% in NSCLC |
| Common Side Effects | Fatigue (29%), rash (21%), pruritus (19%), diarrhea (16%), nausea (14%) | Fatigue (31%), rash (24%), pruritus (17%), diarrhea (17%), nausea (16%) |
| Immune-Related Adverse Events | Pneumonitis (3-6%), colitis (2-3%), hepatitis (1-2%), endocrinopathies (8-10%) | Pneumonitis (4-6%), colitis (2-4%), hepatitis (1-3%), endocrinopathies (7-11%) |
| Biomarker Requirements | PD-L1 expression for some indications; MSI-H/dMMR testing required for certain approvals | PD-L1 expression for some indications; MMR status for CRC indication |
| Approximate Cost (per dose) | Check current pricing | Check current pricing |
Keytruda (Pembrolizumab) - Key Advantages
- Broader FDA approval across more cancer types
- Less frequent dosing schedule (every 3 or 6 weeks)
- Slightly higher response rates in some indications
- Extensive clinical trial data in combination therapies
- First PD-1 inhibitor approved for MSI-H/dMMR tumors
OPDIVO (Nivolumab) - Key Advantages
- Approved for malignant pleural mesothelioma (unique indication)
- Can be combined with ipilimumab for enhanced efficacy
- Extensive real-world safety data
- Multiple dosing options for flexibility
- Strong efficacy in renal cell carcinoma
Clinical Considerations
- •Both drugs have similar mechanisms and efficacy profiles
- •Choice often depends on specific cancer type and stage
- •Combination with other therapies may influence selection
- •Patient-specific factors (comorbidities, prior treatments) are crucial
- •PD-L1 expression levels can guide therapy selection
- •Both require close monitoring for immune-related adverse events
- •Treatment should be administered by oncology specialists
Medical Disclaimer: This comparison is for informational purposes only and should not replace professional medical advice. Treatment decisions should be made by qualified healthcare providers based on individual patient circumstances, clinical guidelines, and the latest research evidence.