Daytime versus evening infusions of immune checkpoint inhibitors
Menée aux Etats-Unis à partir de données portant sur 481 patients atteints d'un mélanome de stade avancé diagnostiqué entre 2012 et 2020 (âge médian : 61 ans), cette étude longitudinale évalue l'association entre le moment de la journée où est dispensée l'immunothérapie (avant ou après 16h30) et l'efficacité, du point de vue de la survie globale, et la toxicité d'inhibiteurs de points de contrôle immunitaire (ipilimumab, nivolumab ou pembrolizumab, dispensés seuls ou en combinaison ; durée médiane de suivi : 27 mois)
The delivery of treatments according to circadian rhythms, known as chronotherapy, has been instrumental in the discovery of oxaliplatin efficacy and safety in colon cancer and the efficacy of neoadjuvant chemotherapy for liver metastases from colorectalcancer in the late 1990s. However, no large trial has tested the chronotherapy hypothesis since 2006, whenpatients with metastatic colorectal cancer recruited between 1998 and 2002 given FOLFOX (a combination of folinic acid, fluorouracil, and oxaliplatin) had similar overallsurvival when receiving conventional or fixed-time chronomodulated therapy. However, this trial showed for the first time the need for sex-specific chronotherapyschedules, with a large and significant survival benefit for chronotherapy in men,but not in women.
The Lancet Oncology 2021