For the Patient: LUAVNIV

Other Names: Treatment of Advanced Non-Small

Cell Lung Cancer Using Nivolumab
LU = LUng
AV = AdVanced
NIV = NIVolumab

ABOUT THIS MEDICATION

What is this drug used for?

 Nivolumab (nye vol' ue mab) is a monoclonal antibody used for the treatment of non-
small cell lung cancer (NSCLC). It is usually given after you have had at least one
other type of chemotherapy.

How does this drug work?

 Nivolumab is a type of protein designed to target and interfere with the growth of
cancer cells in your body.

INTENDED BENEFITS
This treatment is being given to slow down the growth of cancer cells in your body. This
treatment can help with controlling some of the symptoms the cancer may be causing
and may delay or prevent new symptoms from starting.

TREATMENT SUMMARY

How is this drug given?

• Nivolumab is given as an infusion (injection) into a vein. The infusion will last about
30 minutes. You will have an infusion every 2 weeks. This 2 weeks period is called a
cycle.

What will happen when I get this drug?

• A blood test is done before starting each treatment cycle. You will see your
oncologist at least every 2 weeks, before treatments.
• The dose of your treatment may be changed based on your blood test results and/or
other side effects.

BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 1 of 11

Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
OTHER INSTRUCTIONS
• It is very important to report side effects immediately to your doctor. Do not
manage side effects at home without speaking with your doctor. Be aware that
symptoms may be delayed and can develop months after your last dose.

What other drugs or foods can interact with nivolumab?

 Other drugs may interact with nivolumab. Check with your doctor or pharmacist
before you start or stop taking any other drugs including all prescription and non-
prescription medicines, steroids or other medicines that lower your immune
response, vitamins, and herbal supplements.
 The drinking of alcohol (in small amounts) does not appear to affect the safety or
usefulness of nivolumab.

Other important things to know:

 Before you are given nivolumab, talk to your doctor or pharmacist if you:
o have an active condition where your immune system attacks your body
(autoimmune disease), such as ulcerative colitis, Crohn’s disease, lupus,
rheumatoid arthritis or sarcoidosis.
o take other medicines that make your immune system weak. Examples of these
may include steroids, such as prednisone.
o had an organ transplant, such as a kidney transplant.
o have any other medical conditions.
 Nivolumab may damage sperm and may harm the baby if used during pregnancy. It
is best to use birth control while being treated with nivolumab and for at least 5
months after the last dose. Tell your doctor right away if you or your partner
becomes pregnant. Do not breast feed during treatment.
 Nivolumab may pass into your breast milk. Do not breastfeed during treatment
 Tell doctors or dentists that you are being treated with nivolumab before you receive
any treatment from them.

BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 2 of 11

Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
SIDE EFFECTS AND WHAT TO DO ABOUT THEM

Nivolumab may cause serious immune reactions against your own body (autoimmune) affecting many parts.

Are there any risks?

Unexpected and unlikely side effects can occur with any drug treatment. The ones listed below are particularly important for
you to be aware of as they are directly related to the common actions of the drug in your treatment plan.

What is the most important information I should know about SERIOUS SIDE EFFECTS?
 Nivolumab can cause serious side effects in many parts of your body. These side effects are most likely to begin during
treatment; however, side effects can show up months after your last treatment with nivolumab.
 Tell your doctor as soon as possible if you have any of serious side effects listed in the table below or your symptoms get
worse.
 Do not try to treat or diagnose symptoms yourself. Getting medical treatment right away may keep the problem from
becoming more serious.

The following side effects were most frequently reported:

Very common (more than 1 in 10 people)

• diarrhea
• itching, rash
• joint pain
• feeling tired
• feeling less hungry
• cough

BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 3 of 11

Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
 SERIOUS SIDE EFFECTS How common is it?
Inflammation of the intestines (colitis) Common
Symptoms may include:
• diarrhea (loose stools) or more bowel movements than usual. Do not treat the diarrhea (less than 1 in 10 but
yourself. more than 1 in 100)
• blood or mucus in stools or dark, tarry, sticky stools
• severe stomach pain (abdominal pain) or tenderness
Inflammation of the thyroid gland (hyperthyroidism, hypothyroidism) Common
Symptoms may include:
• rapid heart beat (less than 1 in 10 but
• weight loss or gain more than 1 in 100)
• increased sweating
• hair loss
• feeling cold
• constipation or diarrhea
• your voice gets deeper
• muscle aches
• changes in sleep patterns
Inflammation of the pituitary gland (hypophysitis, hypopituitarism, including secondary Common
adrenal insufficiency)
Symptoms may include: (less than 1 in 10 but
• weight loss more than 1 in 100)
• increased sweating, hot flashes
• hair loss (includes facial and pubic)
• feeling cold
• headaches that will not go away or unusual headache
• decreased sex drive
• vision problems
• excessive thirst and urination

BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 4 of 11

Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
 SERIOUS SIDE EFFECTS How common is it?
Inflammation of the lungs (pneumonitis) Common
Symptoms may include:
• shortness of breath (less than 1 in 10 but
• chest pain more than 1 in 100)
• coughing
Problems with muscles Common
Symptoms may include:
• back pain (less than 1 in 10 but
• spasms more than 1 in 100)
• weakness
• muscle pain
Skin problems Common
Symptoms may include:
• rash (less than 1 in 10 but
• dry skin more than 1 in 100)
Problems in other organs (nervous system, eyes) Common
Symptoms may include:
• tingling, numbness, lack of energy (less than 1 in 10 but
• changes in eyesight more than 1 in 100)
• dizziness
Inflammation of the liver (hepatitis) Uncommon
Symptoms may include:
• nausea or vomiting (less than 1 in 100 but
• loss of appetite more than 1 in 1000)
• pain on the right side of your stomach
• yellowing of your skin or the whites of your eyes
• dark urine
• bleeding or bruise more easily than normal
Inflammation of the kidneys (nephritis) Uncommon
Symptoms may include:
• changes in the amount or colour of your urine (less than 1 in 100 but
more than 1 in 1000)

BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 5 of 11

Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
 SERIOUS SIDE EFFECTS How common is it?
Problems in the pancreas Rare
Symptoms may include:
• abdominal pain (less than 1 in 1000
• nausea and vomiting but more than 1 in
10000)
Blood sugar problems (type 1 diabetes mellitus) Rare
Symptoms may include:
• hunger or thirst (less than 1 in 1000
• a need to urinate more often but more than 1 in
• weight loss 10000)
Infusion reactions Rare
Symptoms may include:
• shortness of breath (less than 1 in 1000
• itching or rash but more than 1 in
• dizziness 10000)
• fever
• wheezing
• flushing
• feeling like passing out

BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 6 of 11

Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
 How common
OTHER SIDE EFFECTS MANAGEMENT
is it?
Pain or tenderness may occur where Very rare Apply cool compresses or soak in cool water for 15-20 minutes
the needle was placed. several times a day.
Nausea and vomiting may occur after Common • You may be given a prescription for antinausea drug(s) to
your treatment. Most people have little take before your treatment and/or at home. It is easier to
or no nausea. prevent nausea than treat it once it has occurred, so
follow directions closely.
o Drink plenty of fluids.
o Eat and drink often in small amounts.
• Try the ideas in Food Choices to Help Control Nausea.*
• If nausea and vomiting is persistent and you have other
symptoms of hepatitis, tell your doctor as soon as
possible. (see the table above for serious side effects.)
Fever may sometimes occur. Common • Take acetaminophen (e.g., TYLENOL®) every 4-6 hours, to
a maximum of 4 g (4000 mg) per day.
• If you have other symptoms of colitis, tell your doctor as
soon as possible. (see the table above for serious side
effects.)
Constipation may sometimes occur. Common • Exercise if you can.
• Drink plenty of fluids.
• Try ideas in Suggestions for Dealing with Constipation.*
• If you have other symptoms of colitis, tell your doctor as
soon as possible. (see the table above for serious side
effects.)
Headache may sometimes occur. Common • Take acetaminophen (e.g., TYLENOL®) every 4-6 hours if
needed, to a maximum of 4 g (4000 mg) per day.
• If headache is persistent and you have other symptoms of
inflammation of glands or Inflammation of the nerves ,
tell your doctor as soon as possible. (see the table above
for serious side effects.)

BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 7 of 11

Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
 How common
OTHER SIDE EFFECTS MANAGEMENT
is it?
Loss of appetite and weight loss Very common • Try the ideas in Food Ideas to Help with Decreased
sometimes occur. Appetite.
• If loss of appetite is persistent and you have other
symptoms of hepatitis, tell your doctor as soon as
possible. (see the table above for serious side effects.)
Tiredness and lack of energy may Very common • Do not drive a car or operate machinery if you are feeling
sometimes occur. tired.
• Try the ideas in Your Bank to Energy Savings: Helping
People with Cancer Handle Fatigue.*
• If tiredness is persistent and you have other symptoms of
hepatitis or inflammation of glands, tell your doctor as
soon as possible. (see the table above for serious side
effects.)
Hair loss is rare with nivolumab. Rare If hair loss is a problem, refer to For the Patient: Hair Loss Due
to Chemotherapy.*

*Please ask your oncologist or pharmacist for a copy.

If you experience symptoms or changes in your body that have not been described above but worry you, or in any
symptoms are severe, contact:

________________________ at telephone number:___________________

BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 8 of 11

Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
 SEVERE IMMUNE-MEDIATED ADVERSE REACTIONS
MEDICAL Including enterocolitis, intestinal perforation, hepatitis,
dermatitis (including toxic epidermal necrolysis),
ALERT neuropathy, endocrinopathy, pneumonitis, myositis,
myocarditis and toxicities in other organ systems. Duration
NAME _______________________________ of risk after treatment is unknown.
has received FOR MORE INFORMATION:
BC Cancer – Abbotsford ………………………………………………………….604-851-4710
CHECKPOINT INHIBITOR IMMUNOTHERAPY: BC Cancer - Kelowna ............................................. …..250-712-3900
BC Cancer - Prince George……………………………………………………..250-645-7300
Immune-Mediated Adverse Reactions BC Cancer - Surrey ............................................... .…..604-930-4055
BC Cancer - Vancouver………………………………………..………....…….604-877-6000
ALWAYS CARRY THIS CARD AND SHOW TO BC Cancer - Victoria………………………………………………………………..250-519-5500
www.bccancer.bc.ca/health-professionals/professional-resources/cancer-drug-manual
PHYSICIANS INCLUDING ANESTHETISTS Rev Aug 2018

BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 9 of 11

Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 10 of 11
Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)
BC Cancer Protocol Summary (Patient Version) LUAVNIV Page 11 of 11
Developed: 1 Mar 2017 Revised: 1 Aug 2021 (removal of CAP)