Retrospective study of overall survival impact of timing of ICI admninistrationg in patients with advanced cancer

Previous studies suggested that early time-of day administration of immune checkpoint inhibitors (ICIs) is associated with better outcomes. A retrospective study at The Christie NHS Foundation Trust (Manchester, UK) investigated this effect in 2631 patients with advanced/metastatic lung cancer (45%), melanoma (23%%), renal carcinoma (18%), head and neck cancer (9%), and urothelial cancer (5%) treated between 2018 and 2023. Patients receiving ICIs were grouped according to whether they had ≥ 50% (‘late group’) or < 50% (‘early group’) of cycles after the median time of all treatments. The endpoint was overall survival. Median age of patients was 68.2 years and median infusion time was 12:49 h. At a median follow-up of 32 months, the median overall survival was 13.1 months (95% CI 11.8-14.4) for the late group versus 21.4 months (19.8-24.5) for the early group. Late group was associated with shorter overall survival on both the standard analysis (HR 1.48; 95% CI 1.33-1.63) and time-dependent analysis (1.30; 1.16-1.44). The authors conclude that this study provides evidence in favor of early ICI adminstration. Data from randomized trials are required to confirm these findings.