Mismatch repair deficient (dMMR) or microsatellite instability-high (MSI-H) colorectal cancer (CRC)

Active Ingredient: Nivolumab

Indication for Nivolumab

Population group: only adults (18 years old or older)
Therapeutic intent: Adjunct intent

Nivolumab in combination with ipilimumab is indicated for the treatment of adult patients with mismatch repair deficient or microsatellite instability-high metastatic colorectal cancer after prior fluoropyrimidine-based combination chemotherapy.

For this indication, competent medicine agencies globally authorize below treatments:

3 mg/kg every 3 weeks for the first 4 doses and thereafter 240 mg every 2 weeks

For:

Dosage regimens

Intravenous, 3 milligrams nivolumab per kilogram of body weight, once every 3 weeks, 4 doses in total, over the duration of 15 weeks. Afterwards, intravenous, 240 milligrams nivolumab, once every 2 weeks.

Detailed description

The recommended dose is 3 mg/kg nivolumab in combination with 1 mg/kg ipilimumab administered intravenously every 3 weeks for the first 4 doses. This is then followed by a second phase in which nivolumab monotherapy is administered intravenously at either 240 mg every 2 weeks, as presented in the table below. For the monotherapy phase, the first dose of nivolumab should be administered;

  • 3 weeks after the last dose of the combination of nivolumab and ipilimumab if using 240 mg every 2 weeks.

Recommended doses and infusion times for intravenous administration of nivolumab in combination with ipilimumab for RCC:

 Combination phase, every
3 weeks for 4 dosing cycles
Monotherapy phase
Nivolumab 3 mg/kg over 30 minutes 240 mg every 2 weeks over 30 minutes
Ipilimumab 1 mg/kg over 30 minutes-

Dosage considerations

Nivolumab must not be administered as an intravenous push or bolus injection.

Active ingredient

Nivolumab

Nivolumab is a human immunoglobulin G4 (IgG4) monoclonal antibody (HuMAb), which binds to the programmed death-1 (PD-1) receptor and blocks its interaction with PD-L1 and PD-L2. Nivolumab potentiates T-cell responses, including anti-tumour responses, through blockade of PD-1 binding to PD-L1 and PD-L2 ligands. In syngeneic mouse models, blocking PD-1 activity resulted in decreased tumour growth.

Read more about Nivolumab

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