Impact of Blood Type and Administration Timing on Therapeutic Outcomes of Immune Checkpoint Inhibitors for Patients with Lung Cancer in the Chinese Alpine Region.

May 13, 2026Cancers

Blood type and treatment timing may affect immune therapy results in lung cancer patients from the Chinese Alpine region

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Abstract

Patients treated with immune checkpoint inhibitors before 13:00 had a median overall survival of 34.3 months compared to 22.0 months for those treated later.

Earlier treatment times are associated with better overall survival and progression-free survival outcomes in lung cancer patients.
The objective response rate was significantly higher in patients treated before 13:00 in one cohort.
Blood type O is linked to a higher rate of immune-related adverse events compared to non-O blood types.
Patients with blood type O also showed longer median overall survival than those with non-O blood types.

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BACKGROUND: Although immune function and tumor biology follow circadian rhythms, it is unclear whether optimizing the timing of immunotherapy can enhance clinical outcomes. This study evaluated the association between time-of-day administration of immune checkpoint inhibitors (ICIs) and treatment efficacy, and explored whether blood type modifies ICI response in Chinese lung cancer patients living in an alpine region.

METHODS: We performed a retrospective analysis of 1247 Chinese lung cancer patients treated with first-line chemoimmunotherapy between January 2016 and March 2021 at Harbin Medical University Cancer Hospital (Cohort 1,= 839) and the Fourth Affiliated Hospital of Harbin Medical University (Cohort 2,= 408). Primary endpoints were overall survival (OS) and progression-free survival (PFS) estimated by the Kaplan-Meier method. Secondary endpoints included immune-related adverse events (irAEs), disease control rate (DCR), and objective response rate (ORR). n n

RESULTS: Patients treated before 13:00 had superior outcomes compared with those treated later, with longer mOS (34.3 vs. 22.0 months,< 0.0001) and mPFS (16.7 vs. 12.7 months,< 0.001). The ORR was significantly higher in the before 13:00 group of Cohort 1 (64.4% vs. 55%,= 0.005). Additionally, blood type O was associated with a higher irAEs rate (35.6% vs. 20.1%,< 0.01) and longer mOS (34.5 vs. 23.1 months,< 0.0001) than non-O types. p p p p p

CONCLUSIONS: Time-of-day administration and blood type may influence ICI efficacy, supporting circadian-informed and patient-tailored immunotherapy. These findings support incorporating circadian timing and patient-specific factors into cancer immunotherapy strategies.

Impact of Blood Type and Administration Timing on Therapeutic Outcomes of Immune Checkpoint Inhibitors for Patients with Lung Cancer in the Chinese Alpine Region.

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