If this file opens in Compatibility Mode using Microsoft Word, convert to the latest document format to avoid potential formatting issues.	

OP RESEARCH PRO00037722 ABDELRAHIM CA052002 PHASE1/2 PART 1C	

Types:      Research Oncology Treatment
Synonyms:  PRO00037722, CA052002, 2A, BMS-986340 

Cycle 1	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Vital Signs, Oxygen Saturation (Collected prior to start of treatment nivolumab and BMS-986340) once infusion begins collect every 15 minutes (+- 5 minutes) until 2 hours post BMS-986340 EOI and then (for Parts 1A and 1B only) every 30 minutes (+- 5 minutes) until 6 hours post BMS-986340 EOI.
			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	ECOG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Nursing Orders
  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	ECG (Supine for at least 5 minutes) PARTS 1A & 1B only: C1D1, C3D1 to be performed in triplicate in association with pre-dose & 4 hours post dose. C1D15, C2D1, C2D15 triplicate pre-dose only.
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Labs
  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		  	T3, FREE	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
		  	HCG QUANTITATIVE, SERUM	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	The PK of BMS-986340 will be derived from serum concentration versus time measurements. The PK parameters to be assessed include:  Cmax: maximum concentration  Tmax: time to maximum concentration  AUC(tau): area under the concentration-time curve in 1 dosing interval  Ctau: observed concentration at the end of the dosing interval.
 Individual participant PK parameter values will be derived by non-compartmental analysis and, if appropriate, by population PK methods. Actual times of collection will be used in all PK analyses. For nivolumab, PK parameters to be assessed include:  Ctrough: trough observed concentration  Ceoi: observed concentration at the end of infusion.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Peripheral BM, Serum-Based BMM,Immunophenotyping,Peripheral blood Gene Expression Profiling,Circulating Tumor DNA,Immunogenicity Assessments,Tumor-Based Biomarker assessment,Characterization of Tumor Immune Microenvironment,Tumor Gene Expression Profiling
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	IMMUNOGENICITY ASSESSMENT, 
Samples will be evaluated for development of anti-drug antibody (ADA).
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Nursing Orders
  	TREATMENT CONDITIONS 7	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 100,000.
			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Chemotherapy
☑	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	To change doses, right click on the order and select add order and pick desired dosage from the left hand panel
		☑	INV-BMS-986340 infusion (CA052-002/Pro00037722/Abdelrahim)	Dose: --	Route: intravenous	once over 60 Minutes for 1 dose	Start: S+30			Instructions:	Administer intravenously using 0.2 micron inline filter over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, 20 hours refrigerated. 
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.		☐	INV-BMS-986340 (CA052-002/Pro00037722/Abdelrahim) in sodium chloride 0.9% 100 mL infusion	Dose: --	Route: intravenous	once over 60 Minutes for 1 dose	Start: S+30			Instructions:	Administer intravenously using 0.2 micron inline filter over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, 20 hours refrigerated. 
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-BMS-986340 50 MG/10 ML INTRAVENUS SOLN (CA052-002/PRO00037722/ABDELRAHIM)	Medications	 	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes			☐	INV-BMS-986340 800 mg undiluted infusion (CA052-002/Pro00037722/Abdelrahim)	Dose: 800 mg	Route: intravenous	once over 60 Minutes for 1 dose	Start: S+30			Instructions:	Administer intravenously using 0.2 micron inline filter over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, 20 hours refrigerated. 
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.			Pre-Medications
  	ondansetron (ZOFRAN) tablet 16 mg	Dose: 16 mg	Route: oral	once for 1 dose			Offset: 30 Minutes	Instructions:	Administer 30 minutes before chemotherapy.			Chemotherapy
  	INV-DOCEtaxeL (TAXOTERE)(CA052-002/Pro00037722/Abdelrahim)	Dose: --	Route: intravenous		Start: S			Instructions:	Infuse BMS-986340 first, followed by Docetaxel. Delay 30 minutes after completion of BMS-986340 infusion before beginning docetaxel infusion. Administer intravenously using Non-DEHP tubing over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, protect from light.  
HAZARDOUS - Handle with care
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 2	Perform every 1 day x1		Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Vital Signs, Oxygen Saturation (Collected prior to start of treatment nivolumab and BMS-986340) once infusion begins collect every 15 minutes (+- 5 minutes) until 2 hours post BMS-986340 EOI and then (for Parts 1A and 1B only) every 30 minutes (+- 5 minutes) until 6 hours post BMS-986340 EOI.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	The PK of BMS-986340 will be derived from serum concentration versus time measurements. The PK parameters to be assessed include:  Cmax: maximum concentration  Tmax: time to maximum concentration  AUC(tau): area under the concentration-time curve in 1 dosing interval  Ctau: observed concentration at the end of the dosing interval.
 Individual participant PK parameter values will be derived by non-compartmental analysis and, if appropriate, by population PK methods. Actual times of collection will be used in all PK analyses. For nivolumab, PK parameters to be assessed include:  Ctrough: trough observed concentration  Ceoi: observed concentration at the end of infusion.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Peripheral BM, Serum-Based BMM,Immunophenotyping,Peripheral blood Gene Expression Profiling,Circulating Tumor DNA,Immunogenicity Assessments,Tumor-Based Biomarker assessment,Characterization of Tumor Immune Microenvironment,Tumor Gene Expression Profiling
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	IMMUNOGENICITY ASSESSMENT, 
Samples will be evaluated for development of anti-drug antibody (ADA).
				Day 8	Perform every 1 day x1		Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Vital Signs, Oxygen Saturation (Collected prior to start of treatment nivolumab and BMS-986340) once infusion begins collect every 15 minutes (+- 5 minutes) until 2 hours post BMS-986340 EOI and then (for Parts 1A and 1B only) every 30 minutes (+- 5 minutes) until 6 hours post BMS-986340 EOI.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Labs
  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		  	T3, FREE	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
		  	HCG QUANTITATIVE, SERUM	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	The PK of BMS-986340 will be derived from serum concentration versus time measurements. The PK parameters to be assessed include:  Cmax: maximum concentration  Tmax: time to maximum concentration  AUC(tau): area under the concentration-time curve in 1 dosing interval  Ctau: observed concentration at the end of the dosing interval.
 Individual participant PK parameter values will be derived by non-compartmental analysis and, if appropriate, by population PK methods. Actual times of collection will be used in all PK analyses. For nivolumab, PK parameters to be assessed include:  Ctrough: trough observed concentration  Ceoi: observed concentration at the end of infusion.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Peripheral BM, Serum-Based BMM,Immunophenotyping,Peripheral blood Gene Expression Profiling,Circulating Tumor DNA,Immunogenicity Assessments,Tumor-Based Biomarker assessment,Characterization of Tumor Immune Microenvironment,Tumor Gene Expression Profiling
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	IMMUNOGENICITY ASSESSMENT, 
Samples will be evaluated for development of anti-drug antibody (ADA).
				Day 15	Perform every 1 day x1		Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Vital Signs, Oxygen Saturation (Collected prior to start of treatment nivolumab and BMS-986340) once infusion begins collect every 15 minutes (+- 5 minutes) until 2 hours post BMS-986340 EOI and then (for Parts 1A and 1B only) every 30 minutes (+- 5 minutes) until 6 hours post BMS-986340 EOI.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	ECOG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	The PK of BMS-986340 will be derived from serum concentration versus time measurements. The PK parameters to be assessed include:  Cmax: maximum concentration  Tmax: time to maximum concentration  AUC(tau): area under the concentration-time curve in 1 dosing interval  Ctau: observed concentration at the end of the dosing interval.
 Individual participant PK parameter values will be derived by non-compartmental analysis and, if appropriate, by population PK methods. Actual times of collection will be used in all PK analyses. For nivolumab, PK parameters to be assessed include:  Ctrough: trough observed concentration  Ceoi: observed concentration at the end of infusion.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Peripheral BM, Serum-Based BMM,Immunophenotyping,Peripheral blood Gene Expression Profiling,Circulating Tumor DNA,Immunogenicity Assessments,Tumor-Based Biomarker assessment,Characterization of Tumor Immune Microenvironment,Tumor Gene Expression Profiling
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	IMMUNOGENICITY ASSESSMENT, 
Samples will be evaluated for development of anti-drug antibody (ADA).
					
Cycle 2	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Vital Signs, Oxygen Saturation (Collected prior to start of treatment nivolumab and BMS-986340) once infusion begins collect every 15 minutes (+- 5 minutes) until 2 hours post BMS-986340 EOI and then (for Parts 1A and 1B only) every 30 minutes (+- 5 minutes) until 6 hours post BMS-986340 EOI.
			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	ECOG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Nursing Orders
  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	ECG (Supine for at least 5 minutes) PARTS 1A & 1B only: C1D1, C3D1 to be performed in triplicate in association with pre-dose & 4 hours post dose. C1D15, C2D1, C2D15 triplicate pre-dose only.
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Labs
  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		  	T3, FREE	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
		  	HCG QUANTITATIVE, SERUM	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	The PK of BMS-986340 will be derived from serum concentration versus time measurements. The PK parameters to be assessed include:  Cmax: maximum concentration  Tmax: time to maximum concentration  AUC(tau): area under the concentration-time curve in 1 dosing interval  Ctau: observed concentration at the end of the dosing interval.
 Individual participant PK parameter values will be derived by non-compartmental analysis and, if appropriate, by population PK methods. Actual times of collection will be used in all PK analyses. For nivolumab, PK parameters to be assessed include:  Ctrough: trough observed concentration  Ceoi: observed concentration at the end of infusion.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Peripheral BM, Serum-Based BMM,Immunophenotyping,Peripheral blood Gene Expression Profiling,Circulating Tumor DNA,Immunogenicity Assessments,Tumor-Based Biomarker assessment,Characterization of Tumor Immune Microenvironment,Tumor Gene Expression Profiling
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	IMMUNOGENICITY ASSESSMENT, 
Samples will be evaluated for development of anti-drug antibody (ADA).
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Nursing Orders
  	TREATMENT CONDITIONS 7	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 100,000.
			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Chemotherapy
☑	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	To change doses, right click on the order and select add order and pick desired dosage from the left hand panel
		☑	INV-BMS-986340 infusion (CA052-002/Pro00037722/Abdelrahim)	Dose: --	Route: intravenous	once over 60 Minutes for 1 dose	Start: S+30			Instructions:	Administer intravenously using 0.2 micron inline filter over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, 20 hours refrigerated. 
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.		☐	INV-BMS-986340 (CA052-002/Pro00037722/Abdelrahim) in sodium chloride 0.9% 100 mL infusion	Dose: --	Route: intravenous	once over 60 Minutes for 1 dose	Start: S+30			Instructions:	Administer intravenously using 0.2 micron inline filter over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, 20 hours refrigerated. 
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-BMS-986340 50 MG/10 ML INTRAVENUS SOLN (CA052-002/PRO00037722/ABDELRAHIM)	Medications	 	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes			☐	INV-BMS-986340 800 mg undiluted infusion (CA052-002/Pro00037722/Abdelrahim)	Dose: 800 mg	Route: intravenous	once over 60 Minutes for 1 dose	Start: S+30			Instructions:	Administer intravenously using 0.2 micron inline filter over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, 20 hours refrigerated. 
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.			Pre-Medications
  	ondansetron (ZOFRAN) tablet 16 mg	Dose: 16 mg	Route: oral	once for 1 dose			Offset: 30 Minutes	Instructions:	Administer 30 minutes before chemotherapy.			Chemotherapy
  	INV-DOCEtaxeL (TAXOTERE)(CA052-002/Pro00037722/Abdelrahim)	Dose: --	Route: intravenous		Start: S			Instructions:	Infuse BMS-986340 first, followed by Docetaxel. Delay 30 minutes after completion of BMS-986340 infusion before beginning docetaxel infusion. Administer intravenously using Non-DEHP tubing over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, protect from light.  
HAZARDOUS - Handle with care
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled				Day 5	Perform every 1 day x1		Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Vital Signs, Oxygen Saturation (Collected prior to start of treatment nivolumab and BMS-986340) once infusion begins collect every 15 minutes (+- 5 minutes) until 2 hours post BMS-986340 EOI and then (for Parts 1A and 1B only) every 30 minutes (+- 5 minutes) until 6 hours post BMS-986340 EOI.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Procedures
  	BIOPSY	Interval: --	Occurrences: --	Comments:	Tumor  Biopsy
				Day 8	Perform every 1 day x1		Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Vital Signs, Oxygen Saturation (Collected prior to start of treatment nivolumab and BMS-986340) once infusion begins collect every 15 minutes (+- 5 minutes) until 2 hours post BMS-986340 EOI and then (for Parts 1A and 1B only) every 30 minutes (+- 5 minutes) until 6 hours post BMS-986340 EOI.
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	ECOG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Labs
  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		  	T3, FREE	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
		  	HCG QUANTITATIVE, SERUM	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	The PK of BMS-986340 will be derived from serum concentration versus time measurements. The PK parameters to be assessed include:  Cmax: maximum concentration  Tmax: time to maximum concentration  AUC(tau): area under the concentration-time curve in 1 dosing interval  Ctau: observed concentration at the end of the dosing interval.
 Individual participant PK parameter values will be derived by non-compartmental analysis and, if appropriate, by population PK methods. Actual times of collection will be used in all PK analyses. For nivolumab, PK parameters to be assessed include:  Ctrough: trough observed concentration  Ceoi: observed concentration at the end of infusion.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Peripheral BM, Serum-Based BMM,Immunophenotyping,Peripheral blood Gene Expression Profiling,Circulating Tumor DNA,Immunogenicity Assessments,Tumor-Based Biomarker assessment,Characterization of Tumor Immune Microenvironment,Tumor Gene Expression Profiling
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	IMMUNOGENICITY ASSESSMENT, 
Samples will be evaluated for development of anti-drug antibody (ADA).
					
Cycle 3	Repeat 1 time	Cycle length: 28 days	Day 1	Perform every 1 day x1		Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Cycle 3 and beyond: Vital signs must be collected pre-treatment immediately prior to the start of treatment (nivolumab and BMS-986340). Once
BMS-986340 infusion begins, vital signs must be collected every 30 minutes (approximately ± 5 minutes) until 1 hour post BMS-986340
			Nursing Orders
  	MEASURE WEIGHT	Interval: --	Occurrences: --			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	ECOG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Nursing Orders
  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	ECG (Supine for at least 5 minutes) PARTS 1A & 1B only: C1D1, C3D1 to be performed in triplicate in association with pre-dose & 4 hours post dose. C1D15, C2D1, C2D15 triplicate pre-dose only.
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Labs
  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		  	T3, FREE	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
		  	HCG QUANTITATIVE, SERUM	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
			Research Labs
  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	The PK of BMS-986340 will be derived from serum concentration versus time measurements. The PK parameters to be assessed include:  Cmax: maximum concentration  Tmax: time to maximum concentration  AUC(tau): area under the concentration-time curve in 1 dosing interval  Ctau: observed concentration at the end of the dosing interval.
 Individual participant PK parameter values will be derived by non-compartmental analysis and, if appropriate, by population PK methods. Actual times of collection will be used in all PK analyses. For nivolumab, PK parameters to be assessed include:  Ctrough: trough observed concentration  Ceoi: observed concentration at the end of infusion.
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	Peripheral BM, Serum-Based BMM,Immunophenotyping,Peripheral blood Gene Expression Profiling,Circulating Tumor DNA,Immunogenicity Assessments,Tumor-Based Biomarker assessment,Characterization of Tumor Immune Microenvironment,Tumor Gene Expression Profiling
		  	RESEARCH STUDY SPECIMEN	Interval: --	Occurrences: --	Comments:	IMMUNOGENICITY ASSESSMENT, 
Samples will be evaluated for development of anti-drug antibody (ADA).
			Outpatient Electrolyte Replacement Protocol
  	TREATMENT CONDITIONS 39	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Potassium level LESS than 3.5 mEq/L; 
3. Recent pre-infusion labs.   

Dosing is based on lab value.
o Serum potassium less than 3.0mEq/L, give 40mEq KCL IV or PO and contact MD/NP. 
o Serum potassium 3.0 to 3.2mEq/L, give 40mEq KCL IV or PO. 
o Serum potassium 3.3 to 3.4mEq/L, give 20mEq KCL IV or PO. 
o Serum potassium 3.5 mEq/L or greater, do not give potassium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
		  	TREATMENT CONDITIONS 40 	Interval: --	Occurrences: --	Comments:	The protocol applies only if the following is met. 
1. SCr LESS than 1.5; 
2. Magnesium level LESS than 1.6 mg/dL; 
3. Recent pre-infusion labs. 

Dosing is based on lab value. 
o Serum Magnesium less than 1.0 mg/dL, give 2 gram magnesium sulfate IV and contact MD/NP. 
o Serum Magnesium 1.0 to 1.2 mg/dL, give 2 gram magnesium sulfate IV. 
o Serum Magnesium 1.3 to 1.5 mg/dL, give 1 gram magnesium sulfate IV. 
o Serum Magnesium 1.6 mg/dL or greater, do not give magnesium replacement. 

If patient meets criteria, order THERAPY PLAN called "Outpatient Electrolyte Replacement". 
Sign electrolyte replacement order as Per protocol: cosign required.
			Nursing Orders
  	TREATMENT CONDITIONS 7	Interval: --	Occurrences: --	Comments:	HOLD and notify provider if 
o ANC LESS than 1000; 
o Platelets LESS than 100,000.
			Line Care
  	sodium chloride 0.9% flush 20 mL	Dose: 20 mL	Route: intravenous	PRN	Start: S					Line Care
  	sodium chloride 0.9 % infusion 250 mL	Dose: 250 mL	Route: intravenous	once @ 30 mL/hr for 1 dose	Start: S			Instructions:	To keep vein open.			Chemotherapy
☑	ONC PROVIDER COMMUNICATION 5	Interval: --	Occurrences: --	Comments:	To change doses, right click on the order and select add order and pick desired dosage from the left hand panel
		☑	INV-BMS-986340 infusion (CA052-002/Pro00037722/Abdelrahim)	Dose: --	Route: intravenous	once over 60 Minutes for 1 dose	Start: S+30			Instructions:	Administer intravenously using 0.2 micron inline filter over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, 20 hours refrigerated. 
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.		☐	INV-BMS-986340 (CA052-002/Pro00037722/Abdelrahim) in sodium chloride 0.9% 100 mL infusion	Dose: --	Route: intravenous	once over 60 Minutes for 1 dose	Start: S+30			Instructions:	Administer intravenously using 0.2 micron inline filter over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, 20 hours refrigerated. 
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.	Ingredients:	Name	Type	Dose	Selected	Adds Vol.	INV-BMS-986340 50 MG/10 ML INTRAVENUS SOLN (CA052-002/PRO00037722/ABDELRAHIM)	Medications	 	Main Ingredient	Yes	SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION	QS Base	100 mL	Yes	Yes			☐	INV-BMS-986340 800 mg undiluted infusion (CA052-002/Pro00037722/Abdelrahim)	Dose: 800 mg	Route: intravenous	once over 60 Minutes for 1 dose	Start: S+30			Instructions:	Administer intravenously using 0.2 micron inline filter over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, 20 hours refrigerated. 
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.			Pre-Medications
  	ondansetron (ZOFRAN) tablet 16 mg	Dose: 16 mg	Route: oral	once for 1 dose			Offset: 30 Minutes	Instructions:	Administer 30 minutes before chemotherapy.			Chemotherapy
  	INV-DOCEtaxeL (TAXOTERE)(CA052-002/Pro00037722/Abdelrahim)	Dose: --	Route: intravenous		Start: S			Instructions:	Infuse BMS-986340 first, followed by Docetaxel. Delay 30 minutes after completion of BMS-986340 infusion before beginning docetaxel infusion. Administer intravenously using Non-DEHP tubing over 60 minutes, then flush with NS. Prepared bag is stable for 4 hours at room temperature, protect from light.  
HAZARDOUS - Handle with care
Caution: New Drug-Limited by Federal (USA) Law to Investigational use.			Hematology & Oncology Hypersensitivity Reaction Standing Order
  	ONC NURSING COMMUNICATION 82	Interval: --	Occurrences: --	Comments:	Grade 1 - MILD Symptoms (cutaneous and subcutaneous symptoms only - itching, flushing, periorbital edema, rash, or runny nose)
1. Stop the infusion.
2. Place the patient on continuous monitoring.
3. Obtain vital signs.
4. Administer Normal Saline at 50 mL per hour using a new bag and new intravenous tubing.
5. If greater than or equal to 30 minutes since the last dose of Diphenhydramine, administer Diphenhydramine 25 mg intravenous once.
6. If less than 30 minutes since the last dose of Diphenhydramine, administer Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
7. Notify the treating physician.
8. If no improvement after 15 minutes, advance level of care to Grade 2 (Moderate) or Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 4	Interval: --	Occurrences: --	Comments:	Grade 2 - MODERATE Symptoms (cardiovascular, respiratory, or gastrointestinal symptoms - shortness of breath, wheezing, nausea, vomiting, dizziness, diaphoresis, throat or chest tightness, abdominal or back pain)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
6. Administer Normal Saline at 150 mL per hour using a new bag and new intravenous tubing.
7. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous), Cetirizine 10 mg orally and Famotidine 20 mg intravenous once.
8. If no improvement after 15 minutes, advance level of care to Grade 3 (Severe).
9. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	ONC NURSING COMMUNICATION 83	Interval: --	Occurrences: --	Comments:	Grade 3 – SEVERE Symptoms (hypoxia, hypotension, or neurologic compromise – cyanosis or O2 saturation less than 92%, hypotension with systolic blood pressure less than 90 mmHg, confusion, collapse, loss of consciousness, or incontinence)
1. Stop the infusion.
2. Notify the CERT team and treating physician immediately.
3. Place the patient on continuous monitoring.
4. Obtain vital signs.
5. If heart rate is less than 50 or greater than 120, or blood pressure is less than 90/50 mmHg, place patient in reclined or flattened position.
6. Administer Oxygen at 2 L per minute via nasal cannula. Titrate to maintain O2 saturation of greater than or equal to 92%.
7. Administer Normal Saline at 1000 mL intravenous bolus using a new bag and new intravenous tubing.
8. Administer Hydrocortisone 100 mg intravenous (if patient has allergy to Hydrocortisone, please administer Dexamethasone 4 mg intravenous) and Famotidine 20 mg intravenous once.
9. Administer Epinephrine (1:1000) 0.3 mg subcutaneous.
10. Assess vital signs every 15 minutes until resolution of symptoms or otherwise ordered by covering physician.
		  	diphenhydrAMINE (BENADRYL) injection 25 mg	Dose: 25 mg	Route: intravenous	PRN	Start: S				  	cetirizine (ZyrTEC) tablet 10 mg	Dose: 10 mg	Route: oral	once PRN	Start: S				  	famotidine (PEPCID) injection 20 mg	Dose: 20 mg	Route: intravenous	PRN	Start: S				  	hydrocortisone sodium succinate (Solu-CORTEF) injection 100 mg	Dose: 100 mg	Route: intravenous	PRN					  	dexAMETHasone (DECADRON) IV 4 mg	Dose: 4 mg	Route: intravenous	PRN					  	epINEPHrine (ADRENALIN) 1 mg/1 mL injection 0.3 mg	Dose: 0.3 mg	Route: subcutaneous	PRN	Start: S					Discharge Nursing Orders
  	ONC NURSING COMMUNICATION 76	Interval: --	Occurrences: --	Comments:	Discontinue IV.
			Discharge Nursing Orders
☑	sodium chloride 0.9 % flush 20 mL	Dose: 20 mL	Route: intravenous	PRN					☑	HEParin, porcine (PF) injection 500 Units	Dose: 500 Units	Route: intra-catheter	once PRN	Start: S			Instructions:	Concentration: 100 units/mL. Heparin flush for Implanted Vascular Access Device maintenance.			Discharge Nursing Orders
  	alteplase (CATHFLO) for NON Quinton and NON Hemodialysis Catheters 2 mg	Dose: 2 mg	Route: intra-catheter	once PRN	Start: S			Instructions:	HOLD and notify provider if Platelets LESS than 50.  Instill dose into occluded catheter. Do not force solution into
catheter. After a 30-minute dwell time, assess catheter function by attempting
to aspirate blood. If catheter is functional, aspirate 4 to 5 mL of blood in
patients greater than or equal to 10 kg to remove Cathflo Activase and
residual clots. Gently irrigate the catheter with NS. If catheter remains
nonfunctional, let Cathflo Activase dwell for another 90 minutes (total dwell
time: 120 minutes) and reassess function. If catheter function is not restored,
a second dose may be instilled					
End of Treatment	Repeat 1 time	Cycle length: 1 day	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Cycle 3 and beyond: Vital signs must be collected pre-treatment immediately prior to the start of treatment (nivolumab and BMS-986340). Once
BMS-986340 infusion begins, vital signs must be collected every 30 minutes (approximately ± 5 minutes) until 1 hour post BMS-986340
			Nursing Orders
  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	ECOG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Nursing Orders
  	ECG 12-LEAD	Interval: --	Occurrences: --	Comments:	ECG (Supine for at least 5 minutes) PARTS 1A & 1B only: C1D1, C3D1 to be performed in triplicate in association with pre-dose & 4 hours post dose. C1D15, C2D1, C2D15 triplicate pre-dose only.
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Labs
  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		  	T3, FREE	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
		  	HCG QUANTITATIVE, SERUM	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
					
Follow up 30 days	Repeat 1 time	Cycle length: 1 day	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Oxygen saturation
			Nursing Orders
  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	ECOG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Subsequent Cancer Treatment
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Labs
  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		  	T3, FREE	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
		  	HCG QUANTITATIVE, SERUM	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Assessment of participant survival status
					
Follow up 60 days	Repeat 1 time	Cycle length: 1 day	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Oxygen saturation
			Nursing Orders
  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	ECOG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Subsequent Cancer Treatment
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Labs
  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		  	T3, FREE	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
		  	HCG QUANTITATIVE, SERUM	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Assessment of participant survival status
					
Follow up 100 days	Repeat 1 time	Cycle length: 1 day	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Physical Examination to be done by the PI
			Nursing Orders
  	VITAL SIGNS - T/P/R/BP	Interval: --	Occurrences: --	Comments:	Oxygen saturation
			Nursing Orders
  	ONC NURSING COMMUNICATION 62	Interval: --	Occurrences: --	Comments:	ECOG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Concomitant medication use
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Subsequent Cancer Treatment
			Labs
☑	COMPREHENSIVE METABOLIC PANEL	Interval: --	Occurrences: --		☑	CBC WITH PLATELET AND DIFFERENTIAL	Interval: --	Occurrences: --		☑	MAGNESIUM LEVEL	Interval: --	Occurrences: --			Labs
  	AMYLASE LEVEL	Interval: --	Occurrences: --		  	LIPASE LEVEL	Interval: --	Occurrences: --		  	CREATINE KINASE, TOTAL (CPK)	Interval: --	Occurrences: --		  	C-REACTIVE PROTEIN	Interval: --	Occurrences: --		  	URIC ACID LEVEL	Interval: --	Occurrences: --		  	TROPONIN T	Interval: --	Occurrences: --		  	GGT	Interval: --	Occurrences: --		  	PHOSPHORUS LEVEL	Interval: --	Occurrences: --		  	LDH	Interval: --	Occurrences: --		  	BILIRUBIN DIRECT	Interval: --	Occurrences: --		  	URINALYSIS, DIPSTICK ONLY (REFLEX TO MICROSCOPIC IF NEEDED)	Interval: --	Occurrences: --			Labs
  	THYROID STIMULATING HORMONE	Interval: --	Occurrences: --		  	T3, FREE	Interval: --	Occurrences: --		  	T4, FREE	Interval: --	Occurrences: --			Labs
  	URINALYSIS, AUTOMATED WITH MICROSCOPY	Interval: --	Occurrences: --			Labs
  	HCG QUALITATIVE, SERUM SCREEN	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
		  	HCG QUANTITATIVE, SERUM	Interval: --	Occurrences: --	Comments:	minimum sensitivity 25 IU/L or equivalent units of hCG
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Assessment of participant survival status
					
Survival follow up	Repeat 1 time	Cycle length: 1 day	Day 1	Perform every 1 day x1		Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Subsequent Cancer Treatment
			Nursing Orders
  	ONC NURSING COMMUNICATION	Interval: --	Occurrences: --	Comments:	Assessment of participant survival status