To evaluate the association between the time of day of immune checkpoint inhibitor (ICI) administration and oncologic outcomes, specifically overall survival and progression-free survival, in patients with advanced solid tumors.
Key Findings:
29 studies included, comprising 6129 patients, highlighting the need for further investigation into the timing of ICI administration.
Most studies were retrospective cohort studies (27 out of 29), indicating a potential bias in the findings.
Primary outcomes assessed were overall survival (OS) and progression-free survival (PFS), which are critical for evaluating treatment efficacy.
Significant heterogeneity observed among studies, necessitating sensitivity analyses to ensure robustness of results.
Interpretation:
The timing of ICI administration may influence treatment outcomes, suggesting potential benefits of chronotherapy in cancer treatment, warranting further exploration of underlying mechanisms.
Limitations:
Predominantly retrospective studies limit the strength of evidence, suggesting caution in interpretation.
Only one randomized clinical trial included, highlighting the need for more rigorous studies.
Variability in definitions of early vs late administration and cancer types may affect the generalizability of findings.
Conclusion:
Chronomodulated immunotherapy may enhance treatment efficacy, warranting further investigation in prospective trials to validate these findings and explore optimal administration timing.
by Shota Inoue, Ichiro Tsuboi, Marcin Miszczyk, Keiichiro Miyajima, Navid Roessler, Ahmed R. Alfarhan, Satoshi Katayama, Pierre I. Karakiewicz, Motoo Araki, Shahrokh F. Shariat
