Association between time-of-day of the immune checkpoint inhibitor (ICI) infusion and disease outcomes among patients with metastatic renal cell carcinoma (mRCC).

• DOI: 10.1200/jco.2023.41.6_suppl.678
• Publication Date: 2023-03-14T15:22:32Z
• Authors: Nazli Dizman; Ameish Govindarajan; Zeynep Busra Zengin; Luis A Meza; Nishita Tripathi; Nicolas Sayegh; Daniela V. Castro; Elyse H. Chan; Kyle O. Lee; Sweta R. Prajapati; Matthew I. Feng; Vivian Loo; Makala Pace; Shea O'brien; Erin B. Bailey; Regina Barragan-C...; Alex Chehrazi-Raffle; Xiaochen Li; Neeraj Agarwal; Sumanta Monty Pal
• Keywords: Discontinuation

678 Background: Recent studies have suggested an association between the time-of-day of ICI infusions and disease outcomes, including progression free survival overall survival, among patients with cancer. (Qian et al Lancet Oncology 2021). We sought to identify whether such exists in mRCC receiving ICIs. Methods: Patients treated nivolumab alone, or combination ipilimumab, either first- second-line treatment were retrospectively identified. who received <25% after 4:30 pm assigned early time infusion (TOI) sub-cohort while ≥ 25% late TOI sub-cohort. Objective response rate (ORR, per RECIST 1.1), failure (TTF, defined as from date first discontinuation), (OS) compared across two groups using Cox proportional hazard models before adjustment for potential confounders (age, gender, line treatment, IMDC risk, histologic subtype). Results: A total 145 pts (M:F,102:43) included analysis. Median age was 64 (range 31-89) years, 81.4% had clear cell histology, 75.9% intermediate/poor risk disease. Early 110 (75.9%) 35 (24.1%) patients. Baseline characteristics comparable groups. OS entire cohort 41.7 months (95% CI, 33.0 – Not reached [NR]), a median TTF 6.5 5.0 10.8). ORR 32.7% sub-group versus (p=0.60). 8.3 CI 6.0 12.6), 4.4 2.1 - 10.8) group ratio (HR) 0.79 0.50 1.25; p=0.32). Multivariate analysis showed HR 1.55 0.98 2.57; p=0.06) confounders. The 46.3 32.2 NR) 16.7 0.67 0.37 1.23; p=0.20) univariate analyses 0.61 0.33 1.15; p=0.13) multivariate analyses. Conclusions: Our results demonstrated numerical increase ORR, TOI, difference approaching significance Larger randomized controlled investigations are warranted examine impact chronomodulation on efficacy ICIs cancers, mRCC.