Thanks for letting us know about the Medicare restrictions on dose of nivo. I was unaware of that. We just started our first patients on 480 mg this week – all went well.
Krista, excellent point about not seeing patients for 4 weeks. We had been seeing nivo patients in clinic every 4 weeks after 2-3 cycles of every two weeks if things were going well. They would come in for the nivo infusion with a treatment nurse at the 2 week point, but no formal appt. with an MD or NP. If any AE issues were noted by our nurses, then the patient would be seen by an MD/NP. The new schedule takes away that interim 2 week appt. so we will have to reassess our communication practices. Maybe a phone call to those patients at the two week time point should be instituted.
Let us know your experiences with this practice change.