Several retrospective studies have suggested that earlier time-of-day (ToD) administration of immunochemotherapy may improve treatment efficacy. To prospectively evaluate this, a randomized phase 3 trial examined whether the timing of anti–PD-1 therapy influence outcomes in 210 treatment-naïve patients with stage IIIC–IV non–small cell lung cancer (NSCLC) without driver mutations. Patients were randomized to receive the first four cycles of anti–PD-1 therapy either before or after 3:00 PM.
After a median follow-up of 28.7 months, median progression-free survival (PFS) was 11.3 months in the early ToD group compared with 5.7 months in the late ToD group, equivalent to a hazard ratio (HR) of 0.40 for disease progression. Median overall survival (OS) was also longer with early dosing, at 28.0 months versus 16.8 months, with an HR of 0.42 for death. Notably, circulating CD8+ T cells…
