Parag Roy, Consultant Medical Oncologist at TMH and Meherbai TMH Jamshedpur, shared a post on LinkedIn:
“Exciting breakthrough in oncology! Just published in Nature Medicine: a phase 3 randomized trial showing that the time of day for administering immunochemotherapy can significantly impact outcomes in advanced non-small cell lung cancer (NSCLC).
Trial Design:
In the LungTIME-C01 trial (NCT05549037), 210 treatment-naive patients with stage IIIC–IV NSCLC (no driver mutations) were randomized 1:1 to receive the first four cycles of an anti-PD-1 agent either early (before 3:00 PM) or late (after 3:00 PM). This was combined with standard chemotherapy, and the study aimed to test if circadian timing influences efficacy, building on retrospective data suggesting morning infusions might be better.
Analysis:
After a median follow-up of 28.7 months, the early group had a median progression-free survival (PFS) of 11.3 months vs. 5.7 months in the late group (HR 0.40, 95% CI 0.29–0.55; P < 0.001). Overall survival (OS) was also superior: 28.0 months vs. 16.8 months (HR 0.42, 95% CI 0.29–0.60; P < 0.001). Response rates were higher in the early group (69.5% vs. 56.2%), with no differences in adverse events. Mechanistically, early timing boosted circulating CD8+ T cells and improved the ratio of activated to exhausted T cells.
Take-Home Message:
Timing matters! Administering immunochemotherapy earlier in the day could double PFS and OS benefits without added risks or costs. This simple adjustment, rooted in circadian immunology, has huge potential to optimize standard care for NSCLC patients. Oncologists, let’s discuss integrating this into practice – what are your thoughts?”
Other articles featuring Parag Roy on OncoDaily.
