NIVOLUMAB AND RELATLIMAB

Both nivolumab and relatlimab are sold by the brand name opdualag . It is used as combination
therapy to treat melanoma [1]Both the drugs are immune check point blockers they block
proteins to make immune responses weak. Immune check point inhibitors [2] are more efficient
than solitary agents in various cancers[3]. this combination is authorized for the treatment of
advanced melanoma from age 12 to older people . this combination therapy was first approved in
USA in march 2022. It was also approved by European union in September 2022.
NIVOLUMAB
Nivolumab can be purchased under the trade name OPDIVO it can be used to treat wide variety
of cancers such as melanoma, lung cancer [4], malignant pleural, renal cell carcinoma [5] ,
urothelial carcinoma [6] and gastric cancer[7] mesothelioma [8] vomiting [9] during pregnancy
may harm baby [10] gastroesophageal junction (GEJ) cancer[11].It is used by slow injection in
to a vein[12] etc. It is made to produce in Chinese hamster ovary cells[13] by using recombinant
DNA technology. Nivolumab is allowed for medical use in United States in 2014 [14] .It is on
the World Health Organization List of Essential Medicines.[15]
The side effects that can be noticeable while using nivolumab are bone, joint and muscle pain,
upper respiratory tract [16] infection, loss of appetite. Most of the side effects are short term. The
long-time side effects of immune checkpoint inhibitors are long-lasting remissions very less
information is known about long time side effects some studies have shown that the long-term
effects may be mild. while using nivolumab with chemotherapy [17] would cause injury to the
cerebral nerves outside the brain and spinal cord, abdominal pain constipation and
musculoskeletal pain [18].Nivolumab is a human monoclonal antibody that blocks PD-1 [19] .
These immune checkpoint blockers regain the capacity of T- cells [20] so that they can fight
cancer cells.

Relatlimab
Relatlimab is a monoclonal antibody designed for the treatment of melanoma[1] . It is used in
combination with nivolumab to treat melanoma .The combination of nivolumab and relatlimab
was approved for medical use in the united states in march 2022[2].It was the first commercially
developed anti- LAG-3 antibody , entering clinical trials in 2013 and has garnered interest in the
treatment of variety of cancers f, including leukemia cells [3] and melanoma .the side effects of
this drug are muscle pain or weakness , Bone pain[4] , feeling tired or weak diarrhea[5], upset
stomach , headache, decreaseS
ppetite . relatlimab is a human anti – lymphocyte [6] activation gene 3 protein antibody approved
for the treatment of meta static or unresectable melanoma in combination with nivolumab , an
existing programmed cell death protein 1 inhibitor[7] . It is under development by Bristol –
Myers Squibb[8] . in this way , the two drugs activate immune cells _ unleashing them _so that
they can invade tumors and attack melanoma cells more effectively . three trails[9] presented at
the ASCO Annual Meeting 2023 showed continued success with immunotherapy in patients with
melanoma . In the phase three RELATIVITY -047 trail , nivolumab plus relatlimab showed a
consistent benefit over nivolumab alone in patients with previously untreated metastatic or
unresectable melanoma. Relatlimab is the united states Adopted Name (USAN) and the
international nonproprietary name (INN)[10].

The recommended dosage of OPDUALAG for adult patient and pediatric patients 12 years of
age or older who weight at least 40kg is 480mg . nivolumab and 160mg relatlimab administered
intravenously evert 4 weeks until this is progression with or unacceptable toxicity occurs . with
regards to safety , the effective half life of relatlimab (22.2 days) and predicted decline of steady-
state concentration (after 69 days following the last dose ) .pose further challenge in the
Recognition of delayed TRAEs .