Viewing 11 posts - 1 through 11 (of 11 total)
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  • #4643
    Expert Nurse
    Lisa Kottschade

    Hi all,

    I’m curious what everyone is using for infusion times for Ipi and/or Nivo these days. There is some controversy surrounding this at my institution at this time and I know the shorter infusion times are not approved across all tumor types either.
    Thanks in advance!
    Lisa

    #4647
    Expert Nurse
    Krista Rubin

    This is a very timely question. As a consequence of the release of the practice changing adjuvant therapy data surrounding nivolumab, the volume in our practice has dramatically increased in the past few months. This in turn leads to a busier infusion/treatment center.

    We have been administering ipi over 30 minutes (the 3mg/kg dose) for over a year. We have not seen any increase in infusion reactions.

    We have NOT yet switched to nivo over 30 minutes, however, we are hoping to do so very soon. This is based on a fair amount of published literature demonstrating safety for both ipi + nivo over 30 minutes. I do believe 30 minutes will soon be the “standard” for both ipi + nivo very very soon.

    Would love to hear what others are doing in their practices.

    #4648
    Expert Nurse
    Virginia Seery

    I agree with Krista that we have seen a big increase in volume with nivolumab now being used in the adjuvant setting. We still give ipilimumab over 90 minutes, nivolumab over 60 minutes and pembrolizumab over 30 minutes. It sounds like we are behind with adjusting infusion times, but I will talk with our pharmacy about adjusting them. Thanks for the tip!

    #4653
    Expert Nurse
    Mollie Reed

    We are still administering ipilimumab over 90 min and nivolumab over 60 min. However, I believe that we are in the process of changing the infusion time for nivolumab to 30 minutes across the institution.

    #4660
    Expert Nurse
    Kathleen Madden

    Ipi 3mg/kg is still approved for 90 min infusion, however, the FDA just recently approved the nivo in the metastatic setting to be admin over 30 min.

    Is anyone using flip dose ipi/nivo?

    #4667
    Expert Nurse
    Lisa Kottschade

    Hi Kathy,

    Currently we are not using flip dose Ipi/Nivo (“ipi lite” as we like to refer to it) off clinical trial. Thank you all for the responses, we are still working on infusion times here and this is very helpful.

    #4674
    Expert Nurse
    Rajni Kannan

    The flipped dose clinical trials allow for the Ipillimumab 1mg/kg to be given over 60 min. We have started to do more flipped dozing of Nivolumab 3mg/kg and Ipi 1mg/kg which we are seeing less toxicity with but what appears to be the same response rates to the FDA approved dosing.

    #4676
    Expert Nurse
    Suzanne McGettigan

    We have not incorporated the ipi/nivo flipped doses outside of a clinical trial. We are infusion nivo over 30 min as a single agent. There is some controversy and back and forth continuing with our pharmacy and the approved indications for the 30 min infusion time.

    #4677

    Can you please comment the study that led to the label change for nivolumab monotherapy for metastatic/unresectable from 60 to 30 minutes infusion time? Do you think the label will also change for the adjuvant setting (Which is currently still 60 minutes)?

    #4678
    Expert Nurse
    Rajni Kannan

    Currently Nivolumab is approved for 30 min infusion for all melanoma metastic indications as single agent or in combination with Ipilimumab. However, the adjuvant Nivolumab was approved after the 30 min Nivolumab had been submitted to the FDA. Therefore for adjuvant Nivolumab the label states that it should be given over 60 min. There should be an update to the label soon, and adjuvant Nivolumab will be approved for 30 min infusion. There are several studies to support it’s safety in infusing it over 30 min.

    #4691
    Expert Nurse
    Lisa Kottschade

    Update: We just got an email here yesterday that all non-investigational infusion times for nivolumab will be going to the 30 minute infusions.

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