Opdualag (Nivolumab + Relatlimab)
Immunotherapy for advanced melanoma activates your immune system to attack the cancer cells. Cancer researchers are developing more effective ways to treat advanced melanoma, including using some drugs in combination.
When used together, nivolumab + relatlimab can treat advanced melanoma more effectively than nivolumab on its own. This combination of two immunotherapy drugs can shrink tumors and help patients live longer.
What is Opdualag (Nivolumab + Relatlimab)?
Nivolumab + relatlimab are drugs called checkpoint immunotherapies that work by releasing the brakes of the immune system, allowing it to attack cancer cells. Nivolumab, approved first in melanoma in 2014, targets the immune checkpoint PD-1, and is widely used to treat melanoma and many other cancers. Relatlimab is a drug against a different immune checkpoint, LAG-3, and is the first anti-LAG-3 therapy to earn FDA approval.
Learn more about nivolumab (Opdivo) as a separate single-agent therapy.
How Do Nivolumab + Relatlimab Work Together?
Your immune system uses certain molecules on immune cells that act as checkpoints to prevent attacks on healthy cells and minimize autoimmune disease. Melanoma cells can sometimes take advantage of these checkpoint molecules to avoid being detected by the immune system.
Nivolumab + relatlimab target and block two different checkpoints, which increases your body's immune response. In this way, the two drugs activate immune cells—unleashing them —so that they can invade tumors and attack melanoma cells more effectively.
Nivolumab + relatlimab are systemic, which means that the treatments travel through the bloodstream to reach all parts of the body. Doctors use systemic immunotherapy to treat metastatic cancer, which is cancer that has spread from its original location to other areas of the body.
Which Patients May Benefit from Opdualag?
The U.S. Food and Drug Administration (FDA) approved the use of nivolumab + relatlimab to treat adult and pediatric patients 12 years of age or older who have advanced melanoma:
- Stage III Melanoma that is unresectable (unable to be completely removed by surgery)
- Stage IV Melanoma also known as metastatic disease (melanoma cells that have spread to organs and other parts of the body)
Learn more about melanoma staging.
It is not known if nivolumab + relatlimab is safe and effective when used in children younger than 12 years of age or in children 12 years and older weighing less than 88 pounds (40 kg),
How is Opdualag Given?
Patients receive both medications intravenously (into a blood vein). The standard dose of each medication is 480 mg of nivolumab and 160 mg of relatlimab, infused over 30 minutes. Patients usually continue to take these medications until their melanoma worsens or they experience unacceptable side effects.
What Are the Goals of Opdualag Therapy?
The combination of nivolumab + relatlimab works as a systemic treatment to promote an immune response, with the goals of:
- Controlling melanoma and shrinking tumors anywhere in the body
- Treating symptoms of melanoma
- Helping patients live longer
This combination therapy of antibodies helps build up your immune system, which has an immunological "memory." That means that nivolumab + relatlimab may help your immune system continue to attack melanoma cells even after treatment.
The FDA approval for nivolumab + relatlimab is based on results from the Phase 2/3 RELATIVITY-047 (CA224-047) trial that compared the combination of nivolumab + relatlimab against single-agent nivolumab in patients with previously untreated advanced melanoma. The trial results, published by the New England Journal of Medicine,1 found that patients receiving relatlimab-nivolumab lived for approximately 10.1 months without disease progression (PFS) compared to only 4.6 months for patients receiving nivolumab monotherapy. Side effects were more common among patients receiving the combination therapy, however, overall, it was well tolerated.
Melanoma treatments, like nivolumab + relatlimab, have side effects, which can be more serious when the drugs are combined. Patients should talk with their physician to learn more about the side effects of this combination therapy and other melanoma treatment options.
It is very important to report any side effects that you experience—both mild and serious—to your care team!
What Should I Ask My Doctor About Opdualag?
Not all treatments work for all patients with melanoma, because everyone is different. If you are interested in learning more about the combination of nivolumab + relatlimab, here are some questions you should ask your physicians:
- Am I eligible for nivolumab + relatlimab?
- What is your experience with nivolumab + relatlimab?
- Is this combination therapy a good option for my melanoma treatment?
- Is there an alternative to nivolumab + relatlimab for me?
- How successful has the combination been for patients like me?
- What are the side effects of nivolumab + relatlimab?
- Are there any clinical trials for the combination therapy that I should consider?
- What other treatments are FDA-approved for treating advanced melanoma?
- What are the risks and benefits of the available treatment options?
- What are the goals for my treatment?
- How long will I stay on this treatment?
Need Help Paying for Opdualag?
Patient Assistant Programs (PAPs) are designed so that you still have access to the treatments you need, in any financial circumstance. Learn more about the manufacturer’s patient assistance program and other options here.