Moving to monthly on the popeye juice... any issues?

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Buenos Dias Amigos,

My oncologist is suggesting that subject to bloods and early tests she may want to move me from fortnightly to monthly double doses on the nivo. Has anyone also done this and noticed any pro's or con's as a result? From a time and hassle perspective it would be better but not if it doubles chances of more longer term side effects.

Even if you are not on nivolumab - has anyone had issues in general doing this whilst on immuno?

Thanks peeps!

  • Yes, I have done this with nivo with no issue.  

    Following the initial 4 cycles of the combined ipi/nivo doses I developed inflammation in the kidney, and as a result an impaired eGR (kidney function).  Treatment was stopped for about 6-8 weeks whilst I went on a small steroid dose to reverse the situation.  Monotherapy nivo then re-introduced at a half dose every 2 weeks as a gradual introduction.  Although eGFR decreased again it wasn't low enough to stop treatment.  We continued with this approach every 2 weeks for a bit, then reverted to the "normal" dose and frequency of 4 weeks.  Nothing adverse happened. 

    I actually think there's an admin problem with nivo every 2 weeks.  When I looked at my treatment sheet, there wasn't an "option" for nivo every 2 weeks.  It always said "nivo 4 weekly" with an exception note.  Minor point.  

    Edit:  I just remembered when we changed the frequency to 4 weekly, we kept the bloods at 2 weekly.  Then after a couple  of months cancelled them because everything had stabilised (and I got fed up asking for "extra" bloods and having to explain why!

  • Useful information - thanks very much, appreciated.