How often is nivolumab infused in a treatment cycle?

Standard Nivolumab Infusion Schedule

Nivolumab (Opdivo) is typically infused every 2 weeks (q2w) or every 4 weeks (q4w), depending on the dose, indication, and treatment regimen. Doses range from 240 mg q2w to 480 mg q4w for most approved uses in adults, administered intravenously over 30 minutes.[1]

Schedules by Cancer Type

• Melanoma, NSCLC, RCC, or MSI-H/dMMR tumors (monotherapy): 240 mg every 2 weeks or 480 mg every 4 weeks until disease progression or unacceptable toxicity.
  
• Malignant pleural mesothelioma (with ipilimumab): 360 mg every 3 weeks for up to 2 years.
  
• HCC or esophageal cancer (with ipilimumab): 240 mg every 2 weeks plus ipilimumab 1 mg/kg every 6 weeks.
  
• Urothelial carcinoma: 360 mg every 3 weeks with other agents.
  Regimens adjust for combination therapies, body weight-based dosing in some pediatric cases, or fixed dosing in adults.[1][2]
  
  

Treatment Cycle Length

A cycle aligns with the infusion interval (e.g., 14 days for q2w or 28 days for q4w). Cycles continue indefinitely until progression, with dose delays for toxicity management per protocol.[1]

Factors Affecting Frequency

Dose reductions aren't standard; instead, hold or discontinue for adverse events like immune-related toxicities. Premedication isn't required, but monitoring for infusion reactions is routine. Schedules may vary in clinical trials or off-label use.[2]

[1]: Opdivo Prescribing Information (Bristol Myers Squibb)
[2]: [FDA Label for Nivolumab](https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/125554s ws.html)