In our practice, we tend to see patients every week while on ipi + nivo. We do so in order to pick up early toxicity as soon as possible and intervene accordingly. We typically do not draw routine weekly labs, but have a low threshold to do so depending on a sign or symptom prompting further evaluation.
On occasion, if a patient is not able to attend as frequently, phone calls may be substituted, however, for the most part, this is the exception to the rule.
What is the policy of other practices? How often are patients seen and is it typically by the RN, APP, or MD? Are labs obtained?
We tend to be a large referral center and a majority of our patients are traveling at minimum 1-2 hours each way to get their treatment. Often this is closer to 4-5 hours. We tend to see them every 3 weeks before their treatments. However with that said, we have an online messaging system as well as we have our nurse check in on them hopefully once a week, especially folks that we tend to think may be high risk for side effects. We tend to only get labs every 3 weeks.
Keeping close clinical track of our patients on combination therapy is important for their safety in recognizing irAE’s early on and intervening at the onset if needed. Glad to hear that we have parallel practice approaches!
Thank you so much, Yael, for coming by to check out the site, glad to hear that you like it and we hope that you continue to find it helpful to your practice.