This topic contains 4 replies, has 5 voices, and was last updated by Mollie Reed March 29, 2018 at 9:25 pm.

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  • #4769

    Can you please comment on the recent FDA approval of the 4-week nivolumab dosing schedule? When are you using the 2-week vs 4-week schedule?

    #4770
    Expert Nurse
    Rajni Kannan
    Rajni Kannan

    We are currently moving most of our patients on both adjuvant and maintained Nivolumab to 4 weeks. It is easier on the patient from a time and financial perspective. They don’t have to take time off of work, find childcare, or have to pay Travel expenses as often. We are keeping patients on he 2 week schedule only if they are complicated or may need a little more frequent visits/monitoring.

    #4772
    Expert Nurse
    Krista Rubin
    Krista Rubin

    While less chair time is ideal for patients and staff alike, we have not yet made the move to the 4-week dosing. Two reasons:

    – We are a bit hesitant to go that amount of time between visits. When and if we do make the transition, most likely we would do so with the “trusted” patients 1st. The ones we feel confident they WILL contact us to report a new or changing symptom.

    – More importantly to our group and worth mentioning here is that data from the Checkmate 038 trial (unpublished data- can be provided if you ask BMS for it) demonstrating a higher incidence of Grade 1 and Grade 2 hypersensitivity/ infusion reaction for both nivo monotherapy, and nivo + ipi combination at the 30 minute infusion rate. No high grade reaction, NO deaths.

    So- for now, we will make decisions on case-by-case basis. However, it is nice to have options!!

    #4779
    Expert Nurse
    Virginia Seery
    Virginia Seery

    All good points.

    We have decided to transition some of our reliable, long term patients to every 4 weeks. For complicated patients with multiple issues, we will keep them on every two weeks. New patients are starting on the 2 week schedule and if doing well after 2-3 cycles, we will consider changing to every 4 weeks. We have not yet seen any infusion reactions thus far.

    #4780
    Expert Nurse
    Mollie Reed
    Mollie Reed

    We haven’t switched anyone yet, but our thinking is in line with yours…..we’ll switch the long-term responders who are reliable about reporting changes first and see how that goes before switching the others.

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