Important updates to Nivolumab (OPDIVO®) and Ipilimumab (YERVOY®)

Nivolumab (OPDIVO®) and Ipilumumab (YERVOY®) are immune checkpoint inhibitors. Both are now available on the Pharmaceutical Benefits Scheme (PBS) in Australia for people with advanced cancers, meaning more patients may now be eligible to access this treatment on the PBS.

Nivolumab (OPDIVO®), as monotherapy, has been used for the treatment of relapsed or refractory classical Hodgkin lymphoma after autologous stem cell transplant and treatment with brentuximab vedotin, or after 3 or more lines of systemic therapy that includes autologous HSCT.

This has now been expanded to be used, in combination with doxorubicin, vinblastine, and dacarbazine (AVD), in the treatment of adult and pediatric patients 12 years and older with previously untreated, Stage III or IV classical Hodgkin lymphoma (cHL).

Patients living with lymphoma and their families should discuss treatment options with their specialist. For the list of TGA registered indications and full prescribing details, please refer to the Product Information for OPDIVO (nivolumab) and YERVOY (ipilimumab)..

What are checkpoint inhibitors?

Checkpoint inhibitors are medicines that block the signalling through immune checkpoints in a cell. Lymphoma cells can avoid detection by your immune system. Checkpoint inhibitors allow these checkpoints to be turned on and so lymphoma can be detected.

These checkpoints are a normal part of the immune system and keep immune responses from being too strong. By blocking them, these drugs allow immune cells to respond more strongly to cancer.

Our immune system’s T-cells have proteins on them that turn on an immune response and other proteins that turn it off. These are called checkpoints. Cancer cells sometimes find ways to use these checkpoints to hide from the immune system. They do this by making high levels of proteins to switch off T-cells when the T-cells should really be attacking the cancer cells.

Checkpoint inhibitors work by blocking the proteins that stop the immune system from killing cancer cells. When checkpoint inhibitors block these proteins, this turns the immune system back on and the T-cells can find and destroy the cancer cells. There are many different types of checkpoint inhibitors. Whether you have this treatment depends on what treatment you have had to date and the stage of your cancer.

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Please note:
Lymphoma Australia staff are only able to reply to emails sent in English language.

Useful Definitions

  • Refractory: This means the lymphoma does not get better with treatment. The treatment didn’t work as hoped.
  • Relapsed: This means the lymphoma came back after being gone for a while after treatment.
  • 2nd line treatment: This is the second treatment you get if the first one didn’t work (refractory) or if the lymphoma comes back (relapse).
  • 3rd line treatment: This is the third treatment you get if the second one didn’t work or the lymphoma comes back again.
  • Approved: Available in Australia and listed by the Therapeutics Goods Administration (TGA).
  • Funded: Costs are covered for Australian citizens. This means if you have a Medicare card, you shouldn’t have to pay for the treatment.[WO7]

You need healthy T-cells to make CAR T-cells. For this reason, CAR T-cell therapy cannot be used if you have a T-cell lymphoma – yet.

For more information on CAR T-cells and T-cell lymphoma click here. 

Special Note: Although your T-cells are removed from your blood for CAR T-cell therapy, most of our T-cells live outside of our blood – in our lymph nodes, thymus, spleen and other organs.