Better Together: Opdivo and Yervoy
Written by Nicholas Tien
Bristol Myers Squibb recently developed two immunotherapy medications, Opdivo and Yervoy, to activate the immune system in the fight against different cancers.
These medications work together to address two specific problems that cancer presents in the human body: T-cell identification of cancer cells and an inhibited immune response — the body’s immune system is unable to attack foreign substances in the body as efficiently as usual. This combination, for each approved cancer type, increases the survival rate when compared to the status quo.
Many cancers are able to “disguise” themselves from detection from the immune system which prevents a strong immune response against cancer.
“Tumors use the body’s own immunosuppressive mechanisms to send confusing signals to the immune system” states John Wherry, PhD and distinguished professor at the University of Pennsylvania.
One major problem that this combination therapy addresses is cancer’s ability to evade immune detection. Cancer cells often contain PD-L1 or PD-L2 markers that are compatible with the PD-1 receptor on T-cells. The immune system does not attack cells that are able to bind to the PD-1 receptor because an interaction indicates a “friendly” cell. Opdivo blocks the PD-1 receptor on T-cells (a key cell in the immune response) which blocks the cancer’s mechanism of evading T-cell detection.
Another problem that this combination therapy addresses is cancer’s ability to decrease active T-cell activity. The immune system is regulated by CTLA-4 receptors that cancer is able to bind with, signaling to the body that there is no threat. A decrease in T-cell activity when battling cancer is highly detrimental to recovery. Yervoy is able to block the CTLA-4 receptor which increases the amount of T-cells within the body in the presence of cancer. The immune system is then able to attack cancer cells.
By tackling two of the primary issues that current cancer therapies face, Opdivo and Yervoy is a unique treatment that is helping patients battle cancer more effectively than before.
This combination is not without its faults. Because the medications promote accelerated immune activity, healthy cells are susceptible to being attacked as well. These side effects include lung, intestinal, liver, and skin problems. If a patient reacts severely, the company suggests corticosteroid use until the side effects return to normal levels before resuming treatment.
As Bristol Myers Squibb continues to explore the application of Opdivo plus Yervoy in over 50 different cancer types, the future is bright with immuno-oncology. Abderrahim Oukessou MD, the vice president and thoracic cancers development lead of Bristol Myers, commented on the future of immunotherapy:
“We believe in the power of science to address some of the most challenging diseases of our time, and so we pursue innovations with the goal of transforming patients’ lives”
Photo by @thisisengineering
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“How Combination Therapy Works: OPDIVO® (Nivolumab) + YERVOY® (Ipilimumab).” OPDIVO®(Nivolumab) — 10 Mg/ML Injection for Intravenous Use, Bristol Myers Squibb, www.opdivo.com/about-opdivo/how-the-combination-works-combinationtherapy.
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