Immune checkpoint inhibitor infusion times and clinical outcomes in patients with melanoma

The Oncologist, Journal Year: 2024, Volume and Issue: 30(1)

Published: Aug. 27, 2024

Circadian rhythms impact immune function; a previous study demonstrated that immunotherapy treatment times taking place later in the day correlated with poorer outcomes patients melanoma. However, this finding has not been replicated, and other infusion timing schemas are unexplored. The objective of retrospective, cohort was to determine if time affects outcomes. Five hundred sixteen participants age ≥18 years diagnosed cutaneous, acral, mucosal, or unknown primary melanoma treated >1 nivolumab, pembrolizumab, combination ipilimumab/PD-1 inhibitors were included. Response rate, toxicity overall survival (OS), progression-free (PFS) determined based on timing. Patients ≥1 late (after 4 pm) among their first infusions had slightly response rate compared only pre-4 pm (39.7% vs 44.5%), but no significant associations PFS OS (P = .23, .93, respectively). Multivariable analyses showed statistically association for any post-4 4; median also associated considering all times, we found inferior (median 10.6 38.9 months, P < .0001), numerically 54.6 81.2 .19) ≥20% infusions. models similarly infusions, response, PFS, OS. Late when initial (first 4)

Language: Английский

---

Bright Light Therapy in Cancer: Evidence for Future Research and Therapy

Sleep Medicine Reviews, Journal Year: 2024, Volume and Issue: 75, P. 101945 - 101945

Published: May 7, 2024

Language: Английский

---

Response to Concerns and Insights on Timing of Immunotherapy and Radiotherapy in Head and Neck Cancer

Head & Neck, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 24, 2024

Thank you for your interest and letter regarding our recent article, titled "Effect of time-of-day nivolumab stereotactic body radiotherapy in metastatic head neck squamous cell carcinoma: A secondary analysis a prospective randomized trial" as well enthusiasm about the interaction between circadian rhythm modern treatments cancers originating [1]. We appreciate many points heterogenous biology, non-optimized time thresholds, sample size this study. Despite studies on immune function dating to 1940's, hopefully renewed can ultimately lead improved patient care with interventions simple differential scheduling. While data paper reflects somewhat histologies areas irradiated, literature effect cancer therapy outcomes spans multiple diseases anatomic sites. Notably, impact immunotherapy timing survival has been shown renal melanoma [2, 3], while older investigated chemotherapy breast, liver, colon [4, 5]. Our study is consistent findings from larger retrospective that failed show any seasonality following radiation [6]. there are limitations or type II errors could be cause, it begs another question: underlying biological differences patients tumors limit influence diurnal variation have demonstrated other cancers? The challenge validating windows optimal treatment includes nonuniform reporting, individual variability, unclear window repetitive treatments. Studies vaccinations suggest lymphocyte concentration, specifically naïve CD4 CD8 T-cells, nadir around 4 p.m., thereafter affecting downstream mTOR, AKT, IRF4 signaling [7, 8]. However, used numerous cut points. attempted recapitulate Dr. Qian's assessing mucositis [3, 9]. Sensitivity analyses additional significant difference. Furthermore, no consensus when matters: just first infusion, average timing, some threshold fraction given within certain window? Additionally, we know individuals different rhythms shift workers, these are—to extent—malleable. synchronize mouse interferons [10] likely identify something (steroids, melatonin, potentially phototherapy) recalibrate human rhythms, still lack reliable biomarker infuse radiate. Type error always concern exploratory work, if powered detect 5% then negative primary outcome obviously doesn't preclude smaller effect. unplanned was, by definition, not analysis, so an possible. pointed possible > 10% benefit, perhaps dataset tumors. An ideal would large, prospective, histology, site-specific centralized standardized response assessments. In diverse challenging arena cancers, hard come by. Even cooperative groups combine sites occasionally. had but was pragmatic initial attempt investigate systemic techniques. excited generated look forward further research. Ultimately, meaningful benefit radiotherapy. This reflect biology more immunogenic (e.g., melanoma) error. large unlikely crossing Kaplan–Meier curves saw essentially every sensitivity analysis. Hopefully, work will shed light viral smoking induced tumors, what all subset therapies, non minimally invasive biomarkers assess relevant treatments, magnitude effect—if any—scheduling responses, toxicity, therapies. N.L. consultant advisor Merck, Pfizer, Merck Serono, Sanofi received research funding AstraZeneca, Pfizer (Inst). S.M. Janssen Pharmaceuticals, AstraZeneca Genentech. Data sharing applicable article new were created analyzed

Language: Английский

---

Association of the time of day of chemoradiotherapy and durvalumab with tumor control in lung cancer

Radiotherapy and Oncology, Journal Year: 2024, Volume and Issue: unknown, P. 110658 - 110658

Published: Dec. 1, 2024

Language: Английский

---