Impact of time-of-day (ToD) of single-agent immune-checkpoint inhibitor (ICI) on survival in advanced non–small cell lung cancer (aNSCLC) with PD-L1 ≥ 50%: Analysis of the NOTCH collaborative REAL-SAIF study.

作者：Alfred Chung Pui So, Mary Denholm, Stephen David Robinson, Federico Monaca, Andrew Kidd, Rabia Gul, Mohamed Abdelaziz, David Whithey, Alisha Sattar, Daniah Thomas, Samira Bawany, Philippa Smith, Kaneez Fathima, A Aujayeb, Stephanie Eeckelaers, Sophie Banerjee, Shabnam Rafiq, Sarah Qasim, Pablo Martinez Perez, A. Januszewski · 发表于：Journal of Clinical Oncology · 年份：2026 · DOI：10.1200/jco.2026.44.16_suppl.8602 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Research Studies、Cancer, Stress, Anesthesia, and Immune Response

8602 Background: There is growing evidence and interest in the role of chrono-immunotherapy. Previous studies showing benefit of earlier ToD were limited by small cohorts with heterogenous groups and ToD cut-offs. Using one of the largest UK cohort, we explored this further. Methods: 896 patients treated with 3-weekly ICI monotherapy between 2017-2023 from 16 UK centres were included in this retrospective study. Early 30-day deaths were excluded. Multiple imputations were used for data missing at random (except ToD) with pooled estimates. The primary endpoint was overall survival (OS). A sinusoidal Cox model was used for multivariate analysis to represent the cyclical nature of ToD. Results: Median OS and progression-free survival (PFS) were 19.1 (95%CI 17.2-20.9) and 10.1 (95%CI 9.2-11.7) months. Baseline demographics were median age 70-years, 50% male, 77.3% non-squamous histology, and 91% pembrolizumab as ICI of choice. Mean C1 and C2 ToD was 13:18 and 13:12 respectively. 44.1% and 66.5% of patients received C2 within 1 and 4 hours from prior ToD. ToD was not correlated with age or socioeconomic deprivation. Age (HR 1.01; p =0.008), male sex (HR 1.25; p =0.005), performance status (PS) ≥2 (HR 1.22; p =0.038), squamous histology (HR 1.30; p =0.004), liver metastasis (HR 1.51; p =0.001), albumin (HR 0.98; p <0.001), and neutrophil-lymphocyte ratio (NLR) (HR 1.60; p <0.031) were associated with OS. PS ≥2 (HR 1.23; p =0.026), squamous histology (HR 1.26; p =0.010), album...