Authors
Tommaso Bosetti, Oliver John Kennedy, Raffaele Califano, Tom Waddell, Rob Metcalf, Sophia Kreft, Rebecca Lee, Paul Lorigan
Published in
British journal of cancer. Jul 18, 2026. Epub Jul 18, 2026.
Abstract
Immune checkpoint inhibitors (ICIs) have revolutionised cancer treatment. Previous studies suggested that early time-of-day administration is associated with better outcomes. We performed a retrospective study in patients treated at a large tertiary cancer centre.
Patients receiving ICIs between January 2018 and December 2023 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 (OS). Hazard ratios (HRs) were estimated using Cox models with and without time-dependent variables.
2631 patients with advanced/metastatic lung cancer (45%), melanoma (23%), renal carcinoma (18%), head and neck (9%), and urothelial cancer (5%) were included. Median age was 68.2 years and median infusion time was 12:49 h. At a median follow-up of 32 months, median OS was 13.1 (95% CI 11.8-14.4) vs 21.4 (19.8-24.5) months for late and early group. Late group was associated with shorter OS on both the standard analysis (HR 1.48, 1.33-1.63) and the time-dependent model (HR 1.30, 1.16-1.44).
This study provides further evidence in favour of early ICIs administration with a large sample size and a time-dependent model, which reduces the risk of immortal time bias. Data from randomised trials are required to confirm these findings.
PMID:
42471484
Bibliographic data and abstract were imported from PubMed on 19 Jul 2026.
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