Altering the daily timing of immunotherapy could improve survival in people with cancer

Receiving anticancer immunotherapy earlier in the day may help individuals with cancer live longer. That’s according to a study published in Cancer.

An internal clock (circadian rhythm) affects when different physiological processes (including immune reactions) in the body are active. This might explain why various medications appear to be more effective when taken at certain times of day.

Researchers investigated this phenomenon in 397 patients with extensive-stage small cell lung cancer who received the immunotherapy drugs atezolizumab or durvalumab plus chemotherapy at the Affiliated Cancer Hospital of Xiangya School of Medicine at Central South University, in China, between May 2019 and October 2023.

The team found that patients who received immunochemotherapy before 3:00 pm received the most benefits from treatment. Patients who received treatment before 3:00 pm experienced significantly longer progression-free survival (length of time without cancer progression) and overall survival compared with those treated later. After adjusting for influencing factors, the earlier time of day of administration was associated with a 52% lower risk of cancer progression and a 63% lower risk of death.

“Adjusting infusion timing is a straightforward and easily implementable intervention that can be adopted across diverse health care settings without additional cost,” said senior author Yongchang Zhang, MD, of Central South University. “This study has immediate clinical applicability and the potential to transform current treatment protocols for small cell lung cancer.”