• Ruben Malmberg, Michiel Zietse, Daphne W Dumoulin, HendrikxJeroen J M AJJMADepartment of Pharmacy & Pharmacology and Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, Netherlands., AertsJoachim G J VJGJVDepartment of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, Netherlands., van der VeldtAstrid A MAAMDepartment of Medical Oncology, Erasmus University Medical Center, Rotterdam, Netherlands., KochBirgit C PBCPDepartment of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands., Stefan Sleijfer, and van LeeuwenRoelof W FRWFDepartment of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, Netherlands. Electronic address: r.w.f.vanleeuwen@erasmusmc.n.
• Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Medical Oncology, Erasmus University Medical Center, Rotterdam, Netherlands.
• Lancet Oncol. 2022 Dec 1; 23 (12): e552e561e552-e561.

AbstractImmune checkpoint inhibitors have revolutionised cancer treatment by offering durable responses to many patients with solid and haematological cancers. The high prices and increasing use of immune checkpoint inhibitors put considerable strain on health-care budgets globally. This financial strain could jeopardise patients' access to these anti-cancer therapies. However, substantial evidence suggests that immune checkpoint inhibitors are being administered at doses that exceed the minimum dose required for maximum anti-tumour efficacy. Therefore, investigating and implementing the most cost-effective dosing strategies for immune checkpoint inhibitors are urgently necessary. This Personal View provides an overview of existing data on immune checkpoint inhibitor pharmacology and (novel) dosing strategies for anti-PD-1 therapy with nivolumab and pembrolizumab, with a special focus on cost-effectiveness and saving potential. Furthermore, specific recommendations to guide health-care professionals are provided, through the process of prescribing, rounding, preparing, and administering nivolumab and pembrolizumab in the most practical and cost-effective way possible.Copyright © 2022 Elsevier Ltd. All rights reserved.

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