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Systemic Anti-Cancer Therapy Regimen Library

Home > CRC Metastatic - pembrolizumab 200 mg and ipilimumab 1 mg/kg Q3W, followed by pembrolizumab 400 mg Q6W

CRC Metastatic - pembrolizumab 200 mg and ipilimumab 1 mg/kg Q3W, followed by pembrolizumab 400 mg Q6W

Treatment Overview

Pembrolizumab may continue for up to two years, or until disease progression/toxicity.

Cycles 1 to 4 - 21 days - pembrolizumab and ipilimumab

Cycle length:
21

Administer pembrolizumab first followed by ipilimumab; commence ipilimumab no earlier than 30 minutes after completion of the pembrolizumab infusion.


ipilimumab: Some clinicians may consider dose capping e.g. to 80 mg ipilimumab, based on patient clinician discussion.

Cycles 5 to 20 - 42 days - pembrolizumab monotherapy

Cycle length:
42

Cycle details

Cycles 1 to 4 - 21 days - pembrolizumab and ipilimumab

Medication Dose Route Days Max Duration
pembrolizumab 200 mg flat dosing intravenous 1 30 minutes
ipilimumab * 1 mg/kg intravenous 1 30 minutes

Administer pembrolizumab first followed by ipilimumab; commence ipilimumab no earlier than 30 minutes after completion of the pembrolizumab infusion.


ipilimumab: Some clinicians may consider dose capping e.g. to 80 mg ipilimumab, based on patient clinician discussion.

Cycles 5 to 20 - 42 days - pembrolizumab monotherapy

Medication Dose Route Days Max Duration
pembrolizumab 400 mg flat dosing intravenous 1 30 minutes

Full details

Cycles 1 to 4 - 21 days - pembrolizumab and ipilimumab

Day: 1

Medication Dose Route Max duration Details
pembrolizumab 200 mg flat dosing intravenous 30 minutes
Instructions:

Administer via a sterile, non-pyrogenic, low protein binding 0.2 to 5 micron in-line or add-on filter.
ipilimumab * 1 mg/kg intravenous 30 minutes
Instructions:
  • Commence no earlier than 30 minutes after completion of the pembrolizumab infusion.
  • Administer via a sterile, non-pyrogenic, low protein binding 0.2 to 1.2 micron in-line filter.
  • Some clinicians may consider dose capping e.g. to 80 mg, based on patient clinician discussion.

Cycles 5 to 20 - 42 days - pembrolizumab monotherapy

Day: 1

Medication Dose Route Max duration Details
pembrolizumab 400 mg flat dosing intravenous 30 minutes
Instructions:

Administer via a sterile, non-pyrogenic, low protein binding 0.2 to 5 micron in-line or add-on filter.

Supportive Care Factors

Factor Value
Emetogenicity: Minimal
Hypersensitivity / Infusion related reaction risk: Low - routine premedication not recommended

References

Andre T, Elez E, Van Cutsem E, et al; CheckMate 8HW Investigators. Nivolumab plus Ipilimumab in Microsatellite-Instability-High Metastatic Colorectal Cancer. N Engl J Med. 2024 Nov 28;391(21):2014-2026. , PMID: 39602630

Merck Sharp & Dohme (NZ) Limited. Keytruda New Zealand Data Sheet 11 August 2025 https://www.medsafe.govt.nz/profs/datasheet/k/Keytruda.pdf (Accessed 13 January 2026).

Bristol-Myers Squibb (NZ) Limited. Yervoy New Zealand Data Sheet 25 July 2024. https://www.medsafe.govt.nz/profs/Datasheet/y/yervoyinj.pdf (Accessed 20 November 2025).

Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.