Chrono-immunotherapy as a low-hanging fruit for cancer treatment? A call for pragmatic randomized clinical trials

Mar 3, 2025Journal for immunotherapy of cancer

Using timed immune therapy as an easy opportunity for cancer treatment: A call for practical clinical trials

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Abstract

The increasing use of immune checkpoint inhibitors (ICIs) in cancer treatment raises questions about their efficacy influenced by infusion timing.

  • Observational studies suggest that morning infusion of ICIs may enhance their effectiveness compared to evening infusion.
  • Many patients do not respond to ICIs, which are also associated with high costs and potential toxicity.
  • The time of day for ICI infusion could significantly modulate treatment outcomes, warranting further investigation.
  • Current evidence is limited and necessitates confirmation through pragmatic randomized clinical trials.
  • may be supported by biological mechanisms linked to the circadian regulation of the immune system.

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Key numbers

Up to 4× Increase in Survival
Observed in patients receiving early ICI infusions across 18 studies.
4.8 years
Median OS of 4.8 years
Found in matched analysis of 146 melanoma patients receiving evening infusions.
HR 2.04
HR 2.04 for Evening Infusions
Compared to patients receiving earlier infusions in the MEMOIR study.

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