Kathmandu
Cancer Center
Kathmandu
Cancer Center
You may have been told immunotherapy is too expensive for Nepal, or that you need to go to India. Both of those things have changed. Nivolumab and pembrolizumab are available at Kathmandu Cancer Center today — with evidence-based dosing that reduces cost without compromising outcomes. A Phase III study published in the Journal of Clinical Oncology in 2026 confirms this approach.
Checkpoint immunotherapy at KCC
Send your protocol to confirm drug availability & get a written cost estimate → WhatsApp 9818-226237
Is it available here?
Yes — in Kathmandu
Nivolumab and pembrolizumab available at KCC Tathali since 2022. No need to travel to India.
Can I afford it?
Significantly less than India
Evidence-based flexible dosing. No flights, no accommodation, NHIF coverage preserved. WhatsApp for your specific estimate.
Is it right for my cancer?
Depends on your biomarkers
PD-L1 testing, MSI status, and tumour board review determine eligibility. Send your biopsy report for assessment.
The DELII trial tested nivolumab at just 20 mg every two weeks — one-twelfth of the approved 240 mg standard dose — against standard chemotherapy in patients with advanced solid cancers. Ultra-low-dose nivolumab improved overall survival, reduced severe side effects, and improved quality of life. Published in the Journal of Clinical Oncology, 2026.
KCC has offered evidence-based flexible dosing since 2022 — before this trial was published. The DELII results validate what KCC's oncology team has applied for several years.
"Can immunotherapy work at much lower doses — making treatment more affordable without reducing survival benefit?"
Central question of the DELII Trial · Noronha et al., JCO 2026DELII Trial Results — 500 patients · Advanced solid cancers
KCC has offered flexible-dose immunotherapy since 2022. The DELII trial confirms — not initiates — this approach. If you were told immunotherapy was unaffordable, we would like to discuss your specific situation.
For most families in Nepal, full standard-dose immunotherapy at Indian hospitals is financially impossible — not because of the hospital bill alone, but because of everything surrounding it: flights, accommodation, food, lost income, months away from home.
KCC's evidence-based dosing approach, now validated by a Phase III JCO trial, changes this arithmetic dramatically. A drug cost reduction to 8% of standard dose, combined with zero travel overhead and preserved NHIF coverage, makes immunotherapy genuinely accessible.
Cost estimates depend on cancer type, stage, biomarker profile, and regimen selection. Estimates provided in writing before treatment begins. Based on published data from Noronha et al., JCO 2026. Individual results vary.
Ultra-low-dose uses approximately one-twelfth of the standard drug amount. Dose decisions are always individualised by KCC's tumour board — not a universal prescription.
NHIF advantage: If you treat in Nepal, your NHIF card covers defined immunotherapy drugs within the national tariff. If you treat in India, your NHIF card does not apply — full cost plus all travel expenses with zero NHIF offset.
Checkpoint inhibitors (nivolumab, pembrolizumab) are true immunotherapy — they activate the immune system. Trastuzumab, bevacizumab, and rituximab are targeted therapies — different mechanism, often combined with immunotherapy or chemotherapy. All available at KCC.
These monoclonal antibodies target specific proteins — different mechanism from checkpoint inhibitors. They are frequently combined with immunotherapy or chemotherapy.
T-cells can recognise and destroy abnormal cells, including cancer cells. Cancer survives by producing PD-L1 proteins that act as a disguise — binding to checkpoints on T-cells and switching them off. The cancer becomes invisible.
Nivolumab and pembrolizumab are PD-1 inhibitors — they block the protein cancer uses to switch off your T-cells. When this is blocked, T-cells can see the cancer again and attack it. Instead of poisoning cells, immunotherapy restores your body's own defence system.
Nivolumab is typically given every 2–4 weeks. Pembrolizumab every 3 weeks. Each infusion takes 30–60 minutes at KCC's infusion suite. Between infusions, most patients can work and carry on normal activity. Blood tests are done before each cycle.
Immunotherapy does not cause hair loss, bone marrow suppression, or severe nausea. Its side effects are immune-related — the immune system can become overactivated. Fever, skin rash, diarrhoea, joint pain are common. Rare but serious effects (lung, liver, kidney inflammation) require prompt management. KCC monitors throughout treatment.
Duration depends on the indication, your response, and treatment protocol. Some cancers use immunotherapy for a defined number of cycles (12–24 months). Others use it until progression or unacceptable side effects. Your KCC oncologist specifies the expected duration in the written plan after tumour board review.
Not every cancer responds to immunotherapy. These tests — available at KCC's pathology laboratory — determine whether your cancer is likely to respond, and which drug is appropriate.
Measures how much of the checkpoint protein the tumour expresses. High PD-L1 (TPS ≥ 50%) predicts stronger response to pembrolizumab in lung and head and neck cancers. Required for most first-line pembrolizumab approvals.
MSI-High tumors are highly responsive to immunotherapy across all cancer types. Pembrolizumab is FDA-approved for all MSI-H solid tumors. KCC tests for this in colorectal, endometrial, gastric, and selected other cancers.
High TMB (≥ 10 mut/Mb) cancers have more mutations for the immune system to recognise. Tested in selected cases at KCC.
For targeted therapy decisions alongside or instead of immunotherapy. HER2 testing (IHC/FISH) required before trastuzumab. Available at KCC pathology lab.
If your biopsy was taken elsewhere, bring the paraffin-embedded tissue block or unstained slides. In most cases, new biomarker testing can be done from the same sample — a new biopsy is not required.
Dr. Simit Sapkota, oncologist at Kathmandu Cancer Center, explains what immunotherapy is, how checkpoint inhibitors work, and what patients in Nepal need to know about whether immunotherapy is right for them.
इम्युनोथेरापी भनेको के हो, यो कस्तो बिरामीलाई दिइन्छ र नेपालमा कसरी उपलब्ध छ — डा. सिमित सापकोटाले आफ्नै भाषामा बुझाउनुहुन्छ।
💬 Ask Dr. Simit's team about your caseDr. Simit Sapkota · Medical Oncologist · Kathmandu Cancer Center
CAR-T therapy is an advanced form of immunotherapy where a patient's own T-cells are genetically engineered to attack specific cancer cells. It has produced remarkable results in blood cancers — particularly relapsed or refractory B-cell lymphomas and multiple myeloma — where no other treatment has succeeded.
KCC has active plans and a dedicated page on CAR-T therapy. If you or a family member has relapsed blood cancer and has been told about CAR-T, KCC's team can discuss current options and eligibility.
How CAR-T differs from nivolumab / pembrolizumab
Remove the "off switch" on your existing T-cells so they can see cancer. Drug infused; T-cells are the patient's own, not modified.
Patient's T-cells are removed, genetically reprogrammed in a lab to carry a targeting receptor, then infused back. A living treatment — not a recurring drug.
Immunotherapy is not used for every cancer. These are the types where checkpoint inhibitors or targeted biologics are part of the standard-of-care protocol at KCC.
Eligibility depends on your specific cancer subtype, stage, biomarker results, and performance status. KCC's tumour board reviews every case individually.
💬 Ask about eligibility for my cancerतपाईंलाई भनिएको होला: "इम्युनोथेरापी नेपालमा छैन" वा "यो धेरै महंगो छ।" दुवै कुरा अब सत्य होइनन्। Nivolumab र Pembrolizumab काठमाडौं क्यान्सर सेन्टर (KCC) मा सन् २०२२ देखि उपलब्ध छन्।
२०२६ मा Journal of Clinical Oncology मा प्रकाशित Phase III अध्ययनले प्रमाणित गर्यो कि थोरै मात्रामा nivolumab दिँदा पनि Chemotherapy भन्दा बढी जीवन बचाउँछ र साइड इफेक्ट कम हुन्छ। KCC यही दृष्टिकोण प्रयोग गर्दै आएको छ।
भारतमा इम्युनोथेरापी गर्दा NHIF बिमा काम लाग्दैन — र विमान भाडा, होटल, खाना जोड्दा खर्च धेरै बढ्छ। KCC मा उपचार गर्दा तपाईंको NHIF कार्ड मान्य हुन्छ, घरपरिवार साथमा हुन्छ, र सबै कुराकानी नेपालीमै हुन्छ।
नेपालमा क्यान्सरको इम्युनोथेरापी — काठमाडौंमा निभोलुम्याब र पेम्ब्रोलिजुम्याब उपलब्ध छ। इम्युनोथेरापीको मूल्य नेपालमा भारत भन्दा कम छ। क्यान्सर उपचार नेपाल, CAR-T सेल थेरापी नेपाल, चेकपोइन्ट इनहिबिटर काठमाडौं — KCC मा उपलब्ध।
The drugs are identical. The protocols are identical. The oncologists trained at the same institutions. What changes is everything outside the treatment room.
Yes. Nivolumab (Opdivo) and pembrolizumab (Keytruda) are available at KCC Nepal. You do not need to go to India for checkpoint immunotherapy.
KCC has offered checkpoint inhibitor therapy since 2022. A Phase III study published in the Journal of Clinical Oncology in 2026 confirmed this approach improves survival compared to chemotherapy, with fewer side effects. Read the study on PubMed →
Standard-dose nivolumab (240 mg) costs approximately ₹2,23,377 per infusion in India. Ultra-low-dose nivolumab (20 mg) — the dose studied in the DELII trial — costs approximately ₹18,700. KCC's flexible dosing approach can significantly reduce per-cycle drug cost.
WhatsApp your specific diagnosis and proposed protocol to 9818-226237. KCC provides a written cost estimate within 24 hours for your specific regimen.
Yes. KCC regularly continues immunotherapy for patients who started at RGCI, Tata Memorial, Apollo, Medanta. Your cycles are preserved — you do not restart from zero.
Send by WhatsApp: treatment summary, drug name and dose, most recent blood results, and last cycle date. KCC confirms drug availability within 24–48 hours and schedules your next cycle within 3–5 working days.
NHIF covers selected immunotherapy drugs within its defined treatment package and annual ceiling. KCC's administrative team maps your specific treatment plan against current NHIF coverage at registration — before treatment begins.
Important: NHIF does not apply at Indian hospitals. If you treat in India, you bear the full drug cost plus all travel expenses with zero NHIF offset. For a 6-month immunotherapy course, NHIF savings at KCC can amount to several lakh rupees.
Chemotherapy kills rapidly dividing cells — including cancer cells, but also healthy cells like hair follicles, gut lining, and bone marrow. This is why it causes hair loss, nausea, and low blood counts.
Immunotherapy does not kill cancer cells directly. It removes the disguise cancer uses to hide from your immune system — your own T-cells then attack the cancer. Side effects are immune-related rather than toxic: skin rash, joint pain, or (rarely) organ inflammation.
The DELII trial showed immunotherapy patients had significantly fewer severe side effects (42%) vs chemotherapy (60%), and better quality of life.
The DELII trial compared ultra-low-dose nivolumab (20 mg) against standard chemotherapy — not against full-dose nivolumab (240 mg). The trial showed ultra-low-dose nivolumab improved overall survival, 1-year survival, and quality of life compared to chemotherapy, with statistical significance (HR 0.80, p=0.022).
Dose decisions at KCC are individualised by the oncologist and tumour board based on your cancer type, stage, biomarker profile, and treatment goals. KCC does not apply blanket dose reduction — it applies evidence-based, patient-specific dosing.
KCC's medical oncologists are trained at AIIMS New Delhi, PGI Chandigarh, and other leading Indian institutions — the same training centres that produce senior oncologists at RGCI and Tata Memorial. KCC follows the same NCCN and ESMO international treatment guidelines.
Every patient at KCC is reviewed by a multidisciplinary tumour board (MTB) of medical oncologist, surgical oncologist, radiation oncologist, pathologist, and radiologist — standard for every new case at KCC.
A question not answered here?
💬 WhatsApp your question directlyKCC has been offering checkpoint inhibitor therapy since 2022. A Phase III study published in JCO 2026 confirms the clinical validity of evidence-based flexible dosing. Send your diagnosis or protocol — we will give you a written estimate within 24 hours, before you make any decision.
KCC Tathali · Nala Road, Bhaktapur · WhatsApp 9818-226237 · Sunday–Friday 9am–5pm
Written cost estimate within 24 hours · Consultations in Nepali · Cycles not restarted from India