Nature Medicine：张永昌/杨农团队临床研究证实，早上治疗效果更好，延长肺癌患者生存期

Core Findings - The study published in Nature Medicine demonstrates that the timing of immunochemotherapy significantly affects treatment efficacy in patients with non-small cell lung cancer (NSCLC) [3][4] - Administering treatment before 3 PM leads to a longer progression-free survival (PFS) and overall survival (OS) compared to treatment after 3 PM [7][10] Study Design - The randomized phase 3 trial included 210 treatment-naive patients with advanced NSCLC, who were assigned to receive immunochemotherapy either before or after 3 PM, with a median follow-up of 28.7 months [4][7] Efficacy Results - Patients receiving treatment before 3 PM had a median PFS of 11.3 months, while those treated after 3 PM had a median PFS of 5.7 months, indicating a 60% reduction in the risk of disease progression (HR = 0.40) [7][9] - For overall survival, the early treatment group had a median OS of 28.0 months compared to 16.8 months for the late treatment group, reflecting a 58% reduction in mortality risk (HR = 0.42) [7][9] Immunological Insights - The study found that patients treated in the morning had a higher count of CD8+ T cells in circulation, which are crucial for targeting cancer cells, compared to those treated in the evening [9] - Additionally, the ratio of activated CD8+ T cells to exhausted CD8+ T cells was more favorable in the morning group, suggesting stronger anti-tumor immune functionality [9] Safety Profile - Adverse events were similar between both groups, with no new safety concerns identified, indicating that changing the timing of administration does not increase treatment toxicity [10] Implications for Clinical Practice - This research provides strong prospective evidence for "chronotherapy," suggesting that optimizing treatment timing can significantly enhance the effectiveness of immunochemotherapy without additional costs or drug modifications [10]