Overall survival according to timing of immune checkpoint inhibitors administration in patients with advanced cancer: results from a large single-centre cohort analysis
Menée à partir de données portant sur 2 631 patients atteints d'un cancer de stade avancé ou métastatique traité entre 2018 et 2023 (âge médian : 68,2 ans ; durée médiane de suivi : 32 mois), cette étude de cohorte rétrospective évalue l'efficacité, du point de vue de la survie globale, d'un traitement par inhibiteurs de point de contrôle immunitaire en fonction de l'heure de son administration
Background: 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.
Methods: 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.
Results: 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).
Conclusions: 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.
British Journal of Cancer , article en libre accès, 2026