Retrospective study of association of time of day of radiotherapy and durvalumab infusion with tumor control in locally advanced non-small cell lung cancer

The circadian clock governs the expression of gene related to immunity and DNA repair. A retrospective study at Memorial Sloan Kettering Cancer Center (New York, NY) investigated whether the time of the day of radiotherapy and systemic therapy infusions are associated with disease control in locally advanced non-small cell lung cancer (LA-NSCLC). The study included 178 consecutive patients with inoperable LA-NSCLC who received definitive chemoradiotherapy followed by durvalumab infusion. The median follow-up was 48.0 months from durvalumab infusion. On multivariable analysis, receiving > 50% of radiotherapy sessions within 3 hour of sunset was independently associated with reduced risk of progression (HR 0.39; p=0.017) and distant metastasis (HR 0.27; p=0.007), whereas receiving > 50% of durvalumab infusions within 3 hour of sunset was associated with increased risk of distant metastasis (HR 2.13; p=0.025). The timing of chemotherapy infusion was not associated with disease outcomes. The authors conclude that the time of day of radiotherapy and durvalumab infusion may be associated with disease control in LA-NSCLC.