Immunochemotherapy Infusions Early in the Day Tied to Improved NSCLC Survival

THURSDAY, Feb. 12, 2026 (HealthDay News) — For patients with non-small cell lung cancer (NSCLC), early time-of-day (ToD) infusion of immunochemotherapy is associated with improved progression-free survival (PFS) and overall survival (OS), according to a study published online Feb. 2 in Nature Medicine.

Zhe Huang, from Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University in China, and colleagues randomly assigned (in a 1:1 ratio) 210 patients with treatment-naive stage IIIC to IV NSCLC lacking driver mutations to an early or late ToD group, defined by administration of the first four cycles of an anti-programmed death receptor-1 (PD-1) agent before or after 15:00 hours.

The researchers found that the median PFS was 11.3 and 5.7 months in the early and late ToD groups, respectively, after a median follow-up of 28.7 months, corresponding to a hazard ratio of 0.40 for earlier disease progression. The median OS was 28.0 and 16.8 months in the early and late ToD groups, respectively, corresponding to a hazard ratio of 0.42 for earlier death. Treatment-related adverse events were consistent with the established safety profile; there were no new safety signals. The two groups had no significant differences observed in immune-related adverse events. Morning circulating CD8⁺ T-cells increased in the early ToD group over the first four cycles, while they decreased in the late ToD group. Compared with the late ToD group, the early group had a higher ratio of activated (CD38⁺ HLA-DR⁺) versus exhausted (TIM-3⁺ PD-1⁺) CD8⁺ T-cells.

“These findings have important implications for the routine clinical use of immunochemotherapy, offering a simple and cost-neutral strategy that can be readily implemented without imposing additional financial burden on the health care system,” the authors write.

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