Impact of time-of-day on immune checkpoint inhibitor therapy in cancer patients: an up-to-date clinical review

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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