1064P - Optimizing infusion rates of monoclonal antibodies to save time for oncology day care and patients

Background

Due to increasing incidence of cancer and shortage of hospital resources there is a need for a more time-efficient work process at the hospital-daycare-unit. A large proportion of our patients are treated with monoclonal antibodies. These drugs are administered according to the infusion times stated in the drug label. In this pilot study we investigated if it is safe to reduce total infusion time for nivolumab, ipilimumab or pembrolizumab.

Methods

We included patients who received nivolumab every 3 or 4 weeks (320-480mg), ipilimumab (1 or 3 mg/kg) every 3 or 6 weeks and nivolumab (1 or 3 mg/kg) every 3 weeks or pembrolizumab (100-400mg) every 3-6 weeks. The patients had to receive ≥2 administrations without a previous infusion related reaction (IRR) grade ≥2 before they entered the intervention phase where the infusion time was reduced to respectively 15 and 10 minutes. IRRs were graded according to CTCAE v5.0 and the incidence was calculated. Secondly, patient-reported experience measures (PREM) were collected before and after shorted infusion times.

Results

In total 60 patients, 20 per cohort were included. In the nivolumab cohort one IRR grade 2 occurred during the second standard of care 30-minute infusion, and two IRRs occurred during the 15-minute infusion (one grade 1, and one grade 2). No IRRs occurred during the 10-minute infusions. In the ipilimumab/nivolumab cohort one IRR grade 2 occurred during the second standard of care 30-minute infusion of nivolumab, and one IRR grade 1 during the 10-minute infusion of nivolumab. No IRRs occurred during the infusions of ipilimumab. In the pembrolizumab cohort only one grade 1 IRR occurred during the 10-minute infusion. In all cohorts there was no IRR grade 3 or higher. Of the patients who received shorter infusion times 95% were (very) satisfied. A total of 3045 minutes were saved during the intervention phase.

Conclusions

Shorter infusion times up to 10 minutes for nivolumab, ipilimumab/nivolumab and pembrolizumab were applied without a clinical relevant increase of IRRs. Besides increasing time-efficiency, patients were very satisfied with the reduced infusion times. In conclusion, this strategy for optimizing infusion rates of monoclonal antibodies seems to be safe and for further exploration.

Clinical trial identification

NCT06031233.

Editorial acknowledgement

Legal entity responsible for the study

Isala Hospital.

Funding

Partly funded by BMS and Research Foundation Isala Hospital.

Disclosure

All authors have declared no conflicts of interest.