Nivolumab dosing/protocol

Posted By
juliaT
11/6/2018 7:56pm
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Replies: 1

Hello everyone. First of all, big thanks to everyone for being part of this amazing community. It's a great place to find resources and share your experiences.

I have a bit of a technical question regarding nivolumab dosing/protocol. Hopefully somebody will be able to answer. I recently started receiving nivolumab as an adjuvant therapy for resected stage IV melanoma. In my institution the dosing regimen is still 3mg/kg 60min infusion every second week (I'm getting 260mg in total). Nivo is diluted in 50ml 0.9% sodium chloride IV bag. After the infusion IV line is flushed with 25ml sodium chloride. I found various protocols online which state that nivo dose should be diluted in 100ml sodium chloride IV bag (instead of 50ml) and then the line flushed with 50ml sodium chloride instead of 25ml. Is there any substantial difference between the two protocols in question and is one more preferable than the other? Thanks in advance for your help.

maryb-z - (11/8/2018 - 9:12pm)

Hi Julia,

My local oncologist, who is not a melanoma specialist suggested I follow the every 2-weeks protocol you describe for Nivo but my melanoma specialist who attended the ASCO conference in June and is a part of the committee for the NCCN guidelines felt based on more recent evidence the once a month higher dose is as effective and elicited the same side effects as the twice a month lower dose. I chose the once a month 30-minute infusion (had my 1st one on October 26th) so my life wasn't interrupted so much. If I have harsh side effects my onc did say I could go to the every 2 weeks lower dose schedule. Right now other than exhaustion, I feel like I will stick with the once a month protocol.

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