Overview
- The CANCER study evaluated 397 patients with extensive-stage small cell lung cancer treated with atezolizumab or durvalumab plus chemotherapy at the Affiliated Cancer Hospital of Xiangya, Central South University, between May 2019 and October 2023.
- Infusions given before 3:00 p.m. were associated with significantly longer progression-free and overall survival, with adjusted risks of progression and death reduced by 52% and 63%.
- Researchers binned infusion times in 30-minute windows and identified 3:00 p.m. as the cutoff for maximal benefit, with early-treated patients living roughly seven months longer than those treated later in this cohort.
- The timing effect is biologically plausible given circadian variation in T-cell activity and aligns with prior observational reports, including studies in NSCLC and a meta-analysis favoring earlier checkpoint inhibitor dosing.
- Authors and experts highlight limitations such as the retrospective design and underrepresentation of some subgroups, and they note practical hurdles like clinic scheduling and patient chronotype differences.