Nivolumab (Opdivo)

Key Messages

• CADTH recommends that Opdivo, in combination with platinum-doublet chemotherapy, be reimbursed for the neoadjuvant (early-stage) treatment of adult patients with resectable non–small cell lung cancer (NSCLC) (tumours ≥ 4 cm or node positive) if certain conditions are met.
• Opdivo used with chemotherapy should only be covered when used to treat adult patients with operable early-stage NSCLC whose tumours are 4 cm or more in size or are considered node positive. Opdivo used with chemotherapy should be given before surgery. Patients receiving Opdivo should be in relatively good health (i.e., have a good performance status, as determined by a specialist).
• Opdivo used with chemotherapy should only be reimbursed if prescribed by specialists with experience in managing NSCLC. Opdivo used with chemotherapy should not be reimbursed if used to treat patients who have EGFR or ALK gene abnormalities, patients whose tumour histology is considered large cell neuroendocrine carcinoma, or patients for whom chemotherapy before surgery is inadvisable. The cost of Opdivo must be lowered to be cost-effective and affordable.