Systemic Anti-Cancer Therapy Regimen Library
CRC Metastatic - nivolumab 240 mg and ipilimumab 1 mg/kg Q3W, followed by nivolumab 480 mg Q4W
Treatment Overview
Nivolumab may continue for up to two years, or until disease progression/toxicity.
Cycles 1 to 4 - 21 days - nivolumab and ipilimumab
Administer nivolumab first followed by ipilimumab; commence ipilimumab no earlier than 30 minutes after completion of the nivolumab infusion.
ipilimumab: Some clinicians may consider dose capping e.g. to 80 mg ipilimumab, based on patient clinician discussion.
Cycles 5 to 27 - 28 days - nivolumab monotherapy
Cycle details
Cycles 1 to 4 - 21 days - nivolumab and ipilimumab
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| nivolumab * | 240 mg flat dosing | intravenous | 1 | 30 minutes |
| ipilimumab * | 1 mg/kg | intravenous | 1 | 30 minutes |
Administer nivolumab first followed by ipilimumab; commence ipilimumab no earlier than 30 minutes after completion of the nivolumab infusion.
ipilimumab: Some clinicians may consider dose capping e.g. to 80 mg ipilimumab, based on patient clinician discussion.
Cycles 5 to 27 - 28 days - nivolumab monotherapy
| Medication | Dose | Route | Days | Max Duration |
|---|---|---|---|---|
| nivolumab * | 480 mg flat dosing | intravenous | 1 | 30 minutes |
Full details
Cycles 1 to 4 - 21 days - nivolumab and ipilimumab
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| nivolumab * | 240 mg flat dosing | intravenous | 30 minutes |
Instructions:
Administer via a sterile, non-pyrogenic, low protein binding 0.2 to 1.2 micron in-line filter. |
| ipilimumab * | 1 mg/kg | intravenous | 30 minutes |
Instructions:
|
Cycles 5 to 27 - 28 days - nivolumab monotherapy
Day: 1
| Medication | Dose | Route | Max duration | Details |
|---|---|---|---|---|
| nivolumab * | 480 mg flat dosing | intravenous | 30 minutes |
Instructions:
Administer via a sterile, non-pyrogenic, low protein binding 0.2 to 1.2 micron in-line filter. |
Supportive Care Factors
| Factor | Value |
|---|---|
| Emetogenicity: | Minimal |
| Hypersensitivity / Infusion related reaction risk: | Low - routine premedication not recommended |
References
Bristol-Myers Squibb (NZ) Limited. Opdivo New Zealand Data Sheet 18 September 2025 https://www.medsafe.govt.nz/profs/Datasheet/o/opdivoinf.pdf (Accessed 20 November 2025).
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).
* 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.