S4 Ep65: Pierce Underscores the Importance of 2-Step Verification With Relatlimab/Nivolumab

On this episode of The Vitals, Oncology Nursing News® talks with Amber Pierce RN, BSN, OCN, regional nurse manager at Oncology Hematology Associates, an American Oncology Network partner practice, about the importance of 2-step verification with nivolumab and relatlimab-rmbw (Opdualag), which was approved for patients with unresectable or metastatic melanoma in March 2022.The FDA approval was supported by data from the phase 2/3 RELATIVITY-046 trial (NCT03470922), which demonstrated that patients who received nivolumab/relatlimab as a frontline treatment experienced a median progression-free survival (PFS) that was double that of patients who received nivolumab alone. As Pierce highlights in the discussion, the combination is novel because relatlimab is a LAG-3 inhibitor. Moreover, the combination was approved as a fixed dose regimen comprised of a single intravenous infusion of 480 mg nivolumab and 160 mg relatlimab to be given every 4 weeks. Because of this, it is important that nurses understand the potential risk of medication errors.“I think that’s what makes it really unique, because there are other drugs that have a combination of 2 drugs in them, but they may be dosed only on 1 of the drugs that’s in that vial; whereas this particular drug is a flat dose of 640 [mg],” Pierce says. “That is where there can be some confusion and some misunderstanding between how we are actually dosing these patients,” she adds. Episode Notes“Opdualag is a combination of nivolumab and relatlimab; it is a new combination of the PD-1 inhibitor, which is your nivolumab and the LAG-3 blocking antibody, which is your relatlimab.” Time stamp (TS) 4:13“It is really important for nurses to understand and pay attention to what the drug amount is [with] the medication that they are infusing and [that they are] double checking.” TS 6:56.“As a nurse, we are the last line of defense, so to speak, before [therapies] reach the patient. As nurse, it is our responsibility to make sure that patient safety is a top priority.” TS 8:37PodcastA Look Back at 2022 FDA Approvals in Oncology Online Articles Independent 2-Nurse Verification Process in Distribution of Oral Investigational Chemo/Immunotherapy Proves Helpful Updated PFS Data Continue to Support Nivolumab Plus Relatlimab in Advanced Melanoma Experts Provide an Institutional Perspective on the Safe Handling of Immunotherapy Treatments Video Interviews Stephanie Jackson on Improving the Double Verification Process For High-Alert Medications Expert Talks Significance of Relatlimab/Nivolumab Approval for Metastatic Melanoma ReferenceUS Food and Drug Administration approves first LAG-3-blocking antibody combination, Opdualag (nivolumab and relatlimab-rmbw), as treatment for patients with unresectable or metastatic melanoma. News release. Bristol Myers Squibb; March 18, 2022. Accessed May 16, 2023. https://bit.ly/3wk6PDx