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

IF 4.9 1区 医学 Q1 ONCOLOGY
Matthew T. McMillan , Annemarie Shepherd , Alissa J. Cooper , Adam J. Schoenfeld , Abraham J. Wu , Charles B. Simone II , Puneeth Iyengar , Daphna Y. Gelblum , Jamie E. Chaft , Daniel R. Gomez , Narek Shaverdian
{"title":"Association of the time of day of chemoradiotherapy and durvalumab with tumor control in lung cancer","authors":"Matthew T. McMillan ,&nbsp;Annemarie Shepherd ,&nbsp;Alissa J. Cooper ,&nbsp;Adam J. Schoenfeld ,&nbsp;Abraham J. Wu ,&nbsp;Charles B. Simone II ,&nbsp;Puneeth Iyengar ,&nbsp;Daphna Y. Gelblum ,&nbsp;Jamie E. Chaft ,&nbsp;Daniel R. Gomez ,&nbsp;Narek Shaverdian","doi":"10.1016/j.radonc.2024.110658","DOIUrl":null,"url":null,"abstract":"<div><h3>Background/purpose</h3><div>The circadian clock governs the expression of genes related to immunity and DNA repair. We investigated whether the time of day of radiotherapy and/or systemic therapy infusions (chemotherapy or anti-PD-L1) are associated with disease control and survival in locally advanced non-small cell lung cancer (LA-NSCLC).</div></div><div><h3>Materials/methods</h3><div>178 consecutive patients with inoperable LA-NSCLC who received definitive chemoradiotherapy followed by durvalumab between 5/2017–8/2022 were reviewed. Outcomes evaluated included progression-free survival (PFS), distant metastasis-free survival (DMFS), locoregional control (LRC), and overall survival (OS).</div></div><div><h3>Results</h3><div>At a median follow up of 48.0 mo from durvalumab initiation, median PFS and OS were 26.2 mo and 50.0 mo, respectively. Median LRC and DMFS were not reached and 41.0 mo, respectively. Receiving &gt; 50 % (N = 23) versus ≤ 50 % (N = 155) of radiotherapy treatments within 3 h of sunset was associated with younger age; otherwise, there were no other differences between cohorts. There were no significant differences in characteristics between patients who received &gt; 50 % (N = 23) versus ≤ 50 % (N = 155) of durvalumab infusions within 3 h of sunset. On multivariable analysis, receiving &gt; 50 % of radiotherapy treatments within 3 h of sunset was independently associated with reduced risk for progression (HR 0.39, p = 0.017) and distant metastasis (HR 0.27, p = 0.007); conversely, receiving &gt; 50 % of durvalumab infusions within 3 h of sunset was independently associated with increased risk for distant metastasis (HR 2.13, p = 0.025). The timing of chemotherapy was not associated with disease outcomes.</div></div><div><h3>Conclusion</h3><div>The time of day of radiotherapy and durvalumab infusion may be associated with disease control in LA-NSCLC, and the optimal time of treatment depends on the treatment modality.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"203 ","pages":"Article 110658"},"PeriodicalIF":4.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiotherapy and Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167814024043202","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background/purpose

The circadian clock governs the expression of genes related to immunity and DNA repair. We investigated whether the time of day of radiotherapy and/or systemic therapy infusions (chemotherapy or anti-PD-L1) are associated with disease control and survival in locally advanced non-small cell lung cancer (LA-NSCLC).

Materials/methods

178 consecutive patients with inoperable LA-NSCLC who received definitive chemoradiotherapy followed by durvalumab between 5/2017–8/2022 were reviewed. Outcomes evaluated included progression-free survival (PFS), distant metastasis-free survival (DMFS), locoregional control (LRC), and overall survival (OS).

Results

At a median follow up of 48.0 mo from durvalumab initiation, median PFS and OS were 26.2 mo and 50.0 mo, respectively. Median LRC and DMFS were not reached and 41.0 mo, respectively. Receiving > 50 % (N = 23) versus ≤ 50 % (N = 155) of radiotherapy treatments within 3 h of sunset was associated with younger age; otherwise, there were no other differences between cohorts. There were no significant differences in characteristics between patients who received > 50 % (N = 23) versus ≤ 50 % (N = 155) of durvalumab infusions within 3 h of sunset. On multivariable analysis, receiving > 50 % of radiotherapy treatments within 3 h of sunset was independently associated with reduced risk for progression (HR 0.39, p = 0.017) and distant metastasis (HR 0.27, p = 0.007); conversely, receiving > 50 % of durvalumab infusions within 3 h of sunset was independently associated with increased risk for distant metastasis (HR 2.13, p = 0.025). The timing of chemotherapy was not associated with disease outcomes.

Conclusion

The time of day of radiotherapy and durvalumab infusion may be associated with disease control in LA-NSCLC, and the optimal time of treatment depends on the treatment modality.
肺癌患者放化疗时间和杜伐单抗与肿瘤控制的关系
背景/目的:生物钟控制着免疫和DNA修复相关基因的表达。我们研究了局部晚期非小细胞肺癌(LA-NSCLC)患者的放疗和/或全身治疗输注时间(化疗或抗pd - l1)是否与疾病控制和生存相关。材料/方法:在2017年5月至2022年8月期间,178例连续接受终期放化疗和杜伐单抗治疗的不能手术的LA-NSCLC患者进行了回顾性研究。评估的结果包括无进展生存期(PFS)、无远处转移生存期(DMFS)、局部区域控制(LRC)和总生存期(OS)。结果:从durvalumab开始的中位随访时间为48.0个月,中位PFS和OS分别为26.2个月和50.0个月。中位LRC和DMFS分别为未达到和41.0个月。接收 > 50 % (N = 23)与 ≤50  % (N = 155)内放疗治疗3日落与年轻有关的人力资源;除此之外,队列之间没有其他差异。没有明显的特征差异病人 > 50 % (N = 23)与 ≤50  % (N = 155)中的durvalumab注入3人力资源的日落。在多变量分析中,在日落后3小时内接受 > 50% %的放疗与降低进展风险(HR 0.39, p = 0.017)和远处转移风险(HR 0.27, p = 0.007)独立相关;相反,日落后3小时内接受 > 50% %的durvalumab输注与远处转移风险增加独立相关(HR 2.13, p = 0.025)。化疗时间与疾病结果无关。结论:放疗和杜伐单抗输注的时间可能与LA-NSCLC的疾病控制有关,最佳治疗时间取决于治疗方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Radiotherapy and Oncology
Radiotherapy and Oncology 医学-核医学
CiteScore
10.30
自引率
10.50%
发文量
2445
审稿时长
45 days
期刊介绍: Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信