Study finds that earlier administration may be best.
Receiving anticancer immunotherapy earlier in the day may help individuals with cancer live longer. That’s according to a study published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.
An internal clock, or circadian rhythm, affects when different physiological processes (including immune reactions) in the body are active. This might explain why various medications appear to be more effective when taken at certain times of day.
Researchers investigated this phenomenon in 397 patients with extensive-stage small cell lung cancer who received the immunotherapy drugs atezolizumab or durvalumab plus chemotherapy at the Affiliated Cancer Hospital of Xiangya School of Medicine at Central South University, in China, between May 2019 and October 2023.
The team found that patients who received immunochemotherapy before 3:00 pm received the most benefits from treatment. Patients who received treatment before 3:00 pm experienced significantly longer progression-free survival (length of time without cancer progression) and overall survival compared with those treated later. After adjusting for influencing factors, earlier time of day of administration was associated with a 52% lower risk of cancer progression and a 63% lower risk of death.
“Adjusting infusion timing is a straightforward and easily implementable intervention that can be adopted across diverse healthcare settings without additional cost,” said senior author Yongchang Zhang, MD, of Central South University. “This study has immediate clinical applicability and the potential to transform current treatment protocols for small cell lung cancer.”
Additional information
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. A free abstract of this article will be available via the CANCER Newsroom upon online publication. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, newsroom@wiley.com
Full Citation:
“Overall survival according to time-of-day of immunochemotherapy for extensive-stage small cell lung cancer.” Zhe Huang, Zhaohui Ruan, Shidong Xu, Nachuan Zou, Li Deng, Huan Yan, Jiacheng Dai, Jun Deng, Xue Chen, Jing Wang, Hua Xiang, Liang Zeng, Gang Yin, and Yongchang Zhang. CANCER; Published Online: December 8, 2025 (DOI: 10.1002/cncr.70126).
URL Upon Publication: http://doi.wiley.com/10.1002/cncr.70126
Author Contact: Central South University’s communications office at 695315961@qq.com
About the Journal
CANCER is a peer-reviewed publication of the American Cancer Society integrating scientific information from worldwide sources for all oncologic specialties. The objective of CANCER is to provide an interdisciplinary forum for the exchange of information among oncologic disciplines concerned with the etiology, course, and treatment of human cancer. CANCER is published on behalf of the American Cancer Society by Wiley and can be accessed online. Follow CANCER on X @JournalCancer and Instagram @ACSJournalCancer, and stay up to date with the American Cancer Society Journals on LinkedIn.
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