Publication highlight: does how we dose immunotherapy have a carbon footprint?

Two recent papers — one in Lancet Oncology (Bryant et al., 2024) and one in Lancet Planetary Health (Malmberg et al., 2024) — have looked at the environmental impact of how we prescribe checkpoint inhibitors, specifically pembrolizumab and nivolumab. The findings are interesting - the Bryant et al paper reported modelling based on over 7,000 veterans receiving pembrolizumab found that switching to a 400 mg every-six-weeks schedule was associated with a 20% reduction in CO2 emissions, driven largely by fewer patient journeys to the clinic. The Malmberg et al study adds to this, calling for wider adoption of alternative dosing strategies for PD-1 inhibitors and flagging that more sustainable pharmaceutical production processes also have a role to play. Since Q6W pembrolizumab is now standard in the NHS UK we've already made good progress on this — but there might be more we can do. Is anyone recruiting to the REFINE or REFINE-Lung trials?