Documented practice is to remove the vial, draw the dose, and return it to refrigeration rather than leaving it on the counter during prep
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However, the VA National Criteria for Use guidelines for checkpoint inhibitor initiation explicitly allow use only for ECOG performance status score of 0 or 1 for all immunotherapy agents, with some exceptions for ECOG performance status score of 0 to 2 for nivolumab and pembrolizumab