How time of day may affect immune checkpoint inhibitor treatment in cancer patients

Current evidence suggests that the time of day may influence the efficacy of immune checkpoint inhibitors in cancer treatment.

• Circadian rhythms may modulate normal immune function, affecting specific immune checkpoint molecules and cell populations.
• Several retrospective studies indicate that earlier-in-the-day administration of immune checkpoint inhibitors could lead to more favorable efficacy outcomes.
• A randomized phase III trial is examining the association between the time of day for immune checkpoint inhibitor administration and differences in efficacy.
• The evidence regarding the relationship between time of day and toxicity remains more heterogeneous.
• There is a need for additional multicentre prospective randomized trials to confirm causality and address biases present in retrospective studies.

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