Dose Reductions Possible for Tivozanib With and Without Nivolumab for RCC
Katy Beckermann, MD, PhD, explained that oncology nurses and APPs should be ready to administer and explain dose modifications for patients with RCC.
Oncology nurses and advanced practice providers (APPs) should expect to adjust dosages for tivozanib (Fotivda) with and without nivolumab (Opdivo) in locally advanced or metastatic renal cell carcinoma (RCC), Katy Beckermann, MD, PhD, advised in an interview with Oncology Nursing News.1
She said that nurses and APPs should become familiar with common dose modifications recorded in clinical trials for patients using this combination or monotherapy. Importantly, awareness of these dose changes and the occurrence of adverse effects (AEs) are key considerations for nurses and APPs, according to Beckermann. With those expected dose modifications, oncology nurses and APPs should be prepared to inform patients about the possibility of AEs and subsequent dose reductions.
Beckermann is lead study author of a study presented at the 2025 ASCO Genitourinary Cancers Symposium on the use of tivozanib with and without nivolumab as second- and third-line treatment in locally advanced or metastatic RCC. Results from her research show similar patient-reported outcomes (PROs) between the drug combination and tivozanib monotherapy.
In an interview at the Symposium, Beckermann, an assistant professor in the Department of Medicine, Division of Hematology and Oncology at Vanderbilt School of Medicine in Nashville, Tennessee, sat down to discuss these results.
Transcript
I think it's really important, when we look at clinical trial data, that as we move it into real world practice, we try to adapt the dosing strategy that was given in the clinical trial, and then make ourselves familiar with what the dose modifications were.
‘How many patients require dose reductions?’ and ‘What was the schedule?’ [are things we should be asking]. Acknowledging patients right up front, saying: “If you're having side effects while we're starting at this dose, certainly there may be a need to have dose reduction, and that does not affect, necessarily, the efficacy of the drug,” [is vital].
I think that's the educational points that I often make with my APPs or pharmacists going forward.
Reference
Beckermann K, Choueiri T, Motzer R, et al. Patient-reported outcomes (PROs) for tivozanib (TIVO) + nivolumab (NIVO) vs TIVO monotherapy in patients with renal cell carcinoma (RCC) following an immune checkpoint inhibitor (ICI): results of the phase 3 TiNivo-2 study. J Clin Oncol. 2025;43(suppl 5):459. doi:10.1200/JCO.2025.43.5_suppl.459
